Compositions and methods for treating and preventing influenza

ABSTRACT

This disclosure relates to peptide agents, e.g., antibodies and antigen-binding fragments thereof, that bind hemagglutinin protein of influenza viruses, and methods of their use.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/349,235, filed Nov. 11, 2016, which claims the benefit of U.S.Provisional Application No. 62/255,262, filed Nov. 13, 2015, U.S.Provisional Application No. 62/299,141, filed Feb. 24, 2016, and U.S.Provisional Application No. 62/315,977, filed Mar. 31, 2016. Thecontents of the aforementioned applications are hereby incorporated byreference in their entirety.

SEQUENCE LISTING

The instant application contains a Sequence Listing which has been filedelectronically in ASCII format and is hereby incorporated by referencein its entirety. Said ASCII copy, created on Nov. 2, 2016, is namedP2029-700910_SL.txt and is 186,427 bytes in size.

BACKGROUND

Influenza is an infectious disease caused by RNA viruses of the familyOrthomyxoviridae (the influenza viruses). Influenza viruses areclassified based on core protein into three genera A, B and C that arefurther divided into subtypes determined by the viral envelopeglycoproteins haemagglutinin (HA) and neuraminidase (NA). Influenza Aviruses infect a range of mammalian and avian species, whereas type Band C infections are largely restricted to humans. Only types A and Bcause human disease of any concern.

High mutation rates and frequent genetic reassortments of the influenzaviruses contribute to great variability of the HA and NA antigens. Minorpoint mutations causing small changes (“antigenic drift”) occurrelatively often. Antigenic drift enables the virus to evade immunerecognition, resulting in repeated influenza outbreaks duringinterpandemic years. Major changes in the HA antigen (“antigenic shift”)are caused by reassortment of genetic material from different influenzaA subtypes. Antigenic shifts resulting in new pandemic strains are rareevents, occurring through reassortment between animal and humansubtypes, for example in co-infected pigs.

Influenza A spreads around the world in seasonal epidemics, resulting inthe deaths of between 250,000 and 500,000 people every year, and up tomillions in some pandemic years. On average 41,400 people died each yearin the United States between 1979 and 2001 from influenza.

SUMMARY

The disclosure is based, at least in part, on the discovery of humananti-HA antibodies comprising functional and structural propertiesdisclosed herein, e.g., antibodies that bind a conserved region orepitope on influenza virus, and uses thereof.

Accordingly, the disclosure features binding agents, e.g., antibodymolecules, or preparations, or isolated preparations thereof, that bindhemagglutinin (HA) from influenza viruses. In an embodiment, a bindingagent, e.g., an antibody molecule, is broad spectrum, and binds morethan one HA, e.g., an HA from one or both of Group 1 or Group 2 strainsof influenza A viruses and/or one or more strains of influenza Bviruses. Therefore, in some embodiments, a binding agent, e.g., anantibody molecule, featured in the disclosure can treat or preventinfection by a Group 1 influenza virus and a Group 2 influenza virus. Inother embodiments, a binding agent, e.g., an antibody molecule, featuredin the disclosure can treat or prevent infection by an influenza A virusand/or an influenza B virus. The binding agents, e.g., antibodymolecules, share sufficient structural similarity with antibodies orvariable regions disclosed herein such that they possess functionalattributes of the antibodies disclosed herein. In some embodiments, thestructural similarity can be in terms of three dimensional structure, orlinear amino acid sequence, or both.

In an aspect, the disclosure features a method of treating a subject,e.g., a subject having influenza or at risk for influenza, the methodcomprising administering, or causing to be administered, to the subjectan amount of an anti-HA antibody molecule described herein, e.g., Ab 044(also known as VIS410 herein), of between 2 and 30 mg/kg, therebytreating the subject.

In an embodiment, the subject is treated for influenza, or a disorderassociated with influenza.

In an embodiment, the treatment comprises preventing the subject frominfluenza, or a disorder associated with influenza.

In an embodiment, the amount of the antibody molecule is between 5 and25 mg/kg, between 10 and 20 mg/kg, between 12 and 18 mg/kg, between 14and 16 mg/kg, between 13 and 18 mg/kg, between 8 and 16 mg/kg, between13 and 16 mg/kg, between 11 and 16 mg/kg, between 10 and 15 mg/kg,between 11 and 15 mg/kg, between 8 and 12 mg/kg, or between 10 and 12mg/kg.

In an embodiment, the amount of the antibody molecule is between 14.5and 30 mg/kg, between 14.5 and 25 mg/kg, between 14.5 and 20 mg/kg,between 14.5 and 18 mg/kg, between 14.5 and 16 mg/kg; or between 14.5and 15.5 mg/kg.

In an embodiment, the amount of the antibody molecule is between 15 and30 mg/kg, between 15 and 25 mg/kg, between 15 and 20 mg/kg, between 15and 18 mg/kg, between 15 and 16 mg/kg, or between 15 and 15.5 mg/kg.

In an embodiment, the amount of the antibody molecule is between 9 and14 mg/kg, between 9 and 13 mg/kg, between 9 and 12 mg/kg, between 9 and11 mg/kg, between 9 and 10 mg/kg, between 10 and 14 mg/kg, between 11and 14 mg/kg, between 12 and 14 mg/kg, between 13 and 14 mg/kg, between10 and 13 mg/kg, between 11 and 12 mg/kg, between 10 and 12 mg/kg, orbetween 10 and 11 mg/kg.

In an embodiment, the amount of the antibody molecule is 10 mg/kg, 11mg/kg, 12 mg/kg, 13 mg/kg, 14 mg/kg, or 15 mg/kg. In an embodiment, theamount of the antibody molecule is 15 mg/kg. In an embodiment, theamount of the antibody is 10 mg/kg.

In an embodiment, the subject is administered a single dose of theantibody molecule. In an embodiment, the subject is administered a flatdose of the antibody molecule. In an embodiment, the amount of theantibody molecule administered is between 500 mg and 3000 mg, e.g.,between 1000 mg and 3000 mg, between 1500 mg and 3000 mg, between 2000mg and 3000 mg, between 1800 mg and 2500 mg, between 2500 mg and 3000mg, between 500 mg and 2500 mg, between 500 mg and 2000 mg, between 500mg and 1500 mg, between 500 mg and 1000 mg, between 1000 mg and 2500 mg,between 1500 mg and 2000 mg, or between 2000 mg and 2500 mg, e.g., 1500mg, 1600 mg, 1700 mg, 1800 mg, 1900 mg, 2000 mg, 2100 mg, 2200 mg, 2300mg, 2400 mg, or 2500 mg.

In an embodiment, the antibody molecule is administered intravenously.In an embodiment, the antibody molecule is administered intravenouslyover a period of 1-3 hours, e.g., 1-2 hours or 2-3 hours, e.g., 2 hours.In an embodiment, the subject is administered intravenously at a flatdose (e.g., a single flat dose) between 2000 mg and 2500 mg, e.g.,between 2200 mg and 2400 mg, e.g., 2300 mg.

In an embodiment, the subject is infected, or is at risk of beinginfected, with an influenza virus chose from an H1N1 virus, an H3N2virus, an H7N9 virus, or a combination thereof.

In an embodiment, the antibody molecule does not cause an antibodydependent enhancement (ADE) in the subject, e.g., as determined by amethod described herein. In an embodiment, the antibody molecule isadministered in an amount that does not cause an ADE in the subject,e.g., as determined by a method described herein.

In an embodiment, the antibody molecule does not cause viral resistance,e.g., as determined by a method described herein. In an embodiment, theantibody molecule is administered in an amount that does not cause viralresistance, e.g., as determined by a method described herein.

In an embodiment, the method further comprises detecting an anti-drugantibody (ADA) (e.g., an antibody that binds to or inhibits the anti-HAantibody molecule described herein) in a sample from the subject. In anembodiment, the antibody molecule is administered to a subject who hasnot developed, or has not been detected for having, an ADA to theantibody molecule.

In an embodiment, treating comprises preventing infection (e.g.,influenza virus infection). In an embodiment, the influenza is aseasonal influenza.

In an embodiment, the method comprises administering the antibodymolecule prior to the date, e.g., a day or range of days, of an epidemicpeak of influenza or a disorder associated with influenza, e.g., whereinthe date of the epidemic peak is an expected date for the epidemic peakdetermined prior to the occurrence of the epidemic peak.

In an embodiment, the epidemic peak is in a region that includes: theplace (e.g., street address) where the subject lives; or the city,province or state, in which the subject lives.

In an embodiment, the antibody molecule is administered to a subject 1to 15 weeks prior to the date of an epidemic peak; 2 to 10 weeks priorto the date of an epidemic peak; 3 to 8 weeks prior to the date of anepidemic peak; or 4 to 6 weeks prior to the date of an epidemic peak. Inan embodiment, the antibody molecule is administered to a subject 4 to 8weeks prior to the date of an epidemic peak.

In an embodiment, the subject is between 0 and 15 years of age; between16 and 49 years of age; between 50 and 64 years of age; or 65 years ofage or above. In another embodiment, the subject is at least 30, 40, 50,60, or 65 years of age.

In an embodiment, the subject resides in a single family residence; aresidence, e.g., single family residence, with at least 1 or 2 personsat least 65 years old; an institution, e.g., a retirement facility,assisted living facility, a hospital, nursing home; or an institution inwhich more than 2, 3, 5, 10, 20 or 30 unrelated people, e.g., people atleast 65 years of age, reside.

In an embodiment, administering comprises an intravenous infusion. In anembodiment, administering includes a single intravenous infusion. In anembodiment, administering includes an intravenous infusion over at least20, 30, 40, 50, 60, 90, or 120 minutes.

In an embodiment, the amount of the antibody molecule administered isbetween 10 and 15 mg/kg; the subject is over 65 years of age; and theantibody molecule is administered to the subject 1 to 15 weeks (e.g., 4to 8 weeks) prior to the expected date of an epidemic peak in a regionwhere the subject resides.

In an embodiment, the amount of the antibody molecule administered isbetween 14.5 and 15.5 mg/kg; the subject is over 65 years of age; andthe antibody molecule is administered to the subject 1 to 15 weeks(e.g., 4 to 8 weeks) prior to the expected date of an epidemic peak in aregion where the subject resides.

In an embodiment, the antibody molecule comprises:

(a) a heavy chain immunoglobulin variable region segment comprising: aCDR1 comprising the sequence S-Y-A-M-H (SEQ ID NO:68); a CDR2 comprisingthe sequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and aCDR3 comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P(SEQ ID NO:70); and

(b) a light chain immunoglobulin variable region segment comprising: aCDR1 comprising the sequence Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145); aCDR2 comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73).

In an embodiment, the antibody molecule comprises a heavy chainimmunoglobulin variable region segment that comprises SEQ ID NO: 25. Inan embodiment, the antibody molecule comprises a light chainimmunoglobulin variable region segment that comprises SEQ ID NO: 52. Inan embodiment, the antibody molecule comprises: a heavy chainimmunoglobulin variable region segment that comprises SEQ ID NO: 25 anda light chain immunoglobulin variable region segment that comprises SEQID NO: 52. In an embodiment, the antibody molecule comprises a tetramerof: two heavy chain immunoglobulin variable region segments, eachcomprising SEQ ID NO: 25 and two light chain immunoglobulin variableregion segments, each comprising SEQ ID NO: 52.

In an embodiment, the antibody molecule comprises a full lengthantibody. In an embodiment, the antibody molecule comprises a humanizedantibody molecule. In an embodiment, the antibody molecule comprises twoheavy claim variable regions and two light chain variable regions. In anembodiment, the antibody molecule is an IgG antibody. In an embodiment,the antibody molecule is a single chain antibody (scFv), a F(ab′)₂fragment, a Fab fragment, or an Fd fragment.

In an embodiment, the method further comprises administering to thesubject a second therapeutic agent, e.g., for influenza, or a disorderor symptom associated with influenza.

In an aspect, the disclosure features a method of protecting apopulation of subjects, e.g., from influenza or a disorder associatedwith influenza, comprising administering, and/or causing to beadministered, an anti-HA antibody molecule described herein, e.g., Ab044, to at least 2%, at least 4%, at least 6%, at least 8%, or at least10% of the subjects in the population, thereby protecting thepopulation.

In an embodiment, protection comprises, decreasing, in the population,one or more (e.g., two, three or all) of: the number of hospitaladmissions, e.g. of influenza infected individuals; the number incidentsof influenza infection; the attack rate; or the number of deaths, e.g.of influenza infected individuals.

In an embodiment, the antibody molecule is administered to at least 2%,but not more than 5 or 10% of the subjects in the population. In anotherembodiment, the antibody molecule is administered to at least 4%, butnor more than 8 or 15% of the subjects of the population.

In an embodiment, the method decreases, in the population, one or more(e.g., two, three or all) of: the number of hospital admissions, e.g. ofinfluenza infected individuals; the number incidents of influenzainfection; the attack rate; or the number of deaths, e.g. of influenzainfected individuals.

In an embodiment, (a) the percentage decrease in the number of hospitaladmissions, incidents of influenza infection, attack rate, or deaths,for the population, is greater than (b) the percentage of subjects inthe population receiving the anti-HA antibody molecule. In anembodiment, (a) is at least 2, 3, 4, or 5 times greater than (b).

In an embodiment, the population is all the subjects present in apredefined area. In an embodiment, the population is all the subjectshaving a predefined characteristic, e.g., being at least 65 years ofage, present in a predefined area. In an embodiment, the predefined areais or comprises a city, state, province or other political geographicarea. In an embodiment, the predefined area is or comprises an areahaving a predefined number of subjects. In an embodiment, the predefinedarea is or comprises an area within a preselected distance of apreselected place or landmark.

In an embodiment, the method comprises administering, and/or causing tobe administered, an amount of the antibody molecule of between 2 and 30mg/kg,

In an embodiment, the amount of the amount of the antibody molecule isbetween 5 and 25 mg/kg, between 10 and 20 mg/kg, between 12 and 18mg/kg, between 14 and 16 mg/kg, between 13 and 18 mg/kg, between 8 and16 mg/kg, between 11 and 16 mg/kg, between 13 and 16 mg/kg, between 10and 15 mg/kg, between 11 and 15 mg/kg, between 8 and 12 mg/kg, orbetween 10 and 12 mg/kg.

In an embodiment, the amount of the antibody molecule is between 14.5and 30 mg/kg, between 14.5 and 25 mg/kg, between 14.5 and 20 mg/kg,between 14.5 and 18 mg/kg, between 14.5 and 16 mg/kg; or between 14.5and 15.5 mg/kg.

In an embodiment, the amount of the antibody molecule is between 15 and30 mg/kg, between 15 and 25 mg/kg, between 15 and 20 mg/kg, between 15and 18 mg/kg, between 15 and 16 mg/kg, or between 15 and 15.5 mg/kg.

In an embodiment, the amount of the antibody molecule is between 9 and14 mg/kg, between 9 and 13 mg/kg, between 9 and 12 mg/kg, between 9 and11 mg/kg, between 9 and 10 mg/kg, between 10 and 14 mg/kg, between 11and 14 mg/kg, between 12 and 14 mg/kg, between 13 and 14 mg/kg, between10 and 13 mg/kg, between 11 and 12 mg/kg, between 10 and 12 mg/kg, orbetween 10 and 11 mg/kg.

In an embodiment, the amount of the antibody molecule is 10 mg/kg, 11mg/kg, 12 mg/kg, 13 mg/kg, 14 mg/kg, or 15 mg/kg. In an embodiment, theamount of the antibody molecule is 15 mg/kg. In an embodiment, theamount of the antibody is 10 mg/kg.

In an embodiment, the subject is at risk for influenza, e.g., seasonalinfluenza.

In an embodiment, the method comprises administering the antibodymolecule prior to the date, e.g., a day or range of days, of an epidemicpeak of influenza or a disorder associated with influenza, e.g., whereinthe date of the epidemic peak is an expected date for the epidemic peakdetermined prior to the occurrence of the epidemic peak.

In an embodiment, the epidemic peak is in a region that includes: theplace (e.g., street address) where the subject lives; or the city,province or state, in which the subject lives.

In an embodiment, the antibody molecule is administered, and/or causingto be administered, to a subject 1 to 15 weeks prior to the date of anepidemic peak; 2 to 10 weeks prior to the date of an epidemic peak; 3 to8 weeks prior to the date of an epidemic peak; or 4 to 6 weeks prior tothe date of an epidemic peak. In an embodiment, the antibody molecule isadministered to a subject 4 to 8 weeks prior to the date of an epidemicpeak.

In an embodiment, the subject is between 0 and 15 years of age; between16 and 49 years of age; between 50 and 64 years of age; or 65 years ofage or above. In another embodiment, the subject is at least 30, 40, 50,55, 60, or 65 years of age. In an embodiment, the average age of thesubjects in the population is at least 30, 40, 50, 55, 60, or 65.

In an embodiment, the subject resides in a single family residence; aresidence, e.g., a single family residence, with at least 1 or 2 personsat least 65 years old; an institution, e.g., a retirement facility,assisted living facility, a hospital, nursing home; or an institution inwhich more than 2, 3, 5, 10, 20 or 30 unrelated people, e.g., people atleast 65 years of age, reside.

In an embodiment, administering comprises an intravenous infusion. In anembodiment, administering includes a single intravenous infusion. In anembodiment, administering includes an intravenous infusion over at least20, 30, 40, 50, 60, 90, or 120 minutes.

In an embodiment, the amount of the antibody molecule administered isbetween 10 and 15 mg/kg; the subject is over 65 years of age; and theantibody molecule is administered to the subject 1 to 15 weeks (e.g., 4to 8 weeks) prior to the expected date of an epidemic peak in a regionwhere the subject resides.

In an embodiment, the amount of the antibody molecule administered isbetween 14.5 and 15.5 mg/kg; the subject is over 65 years of age; andthe antibody molecule is administered to the subject 1 to 15 weeks(e.g., 4 to 8 weeks) prior to the expected date of an epidemic peak in aregion where the subject resides.

In an embodiment, the antibody molecule comprises:

(a) a heavy chain immunoglobulin variable region segment comprising: aCDR1 comprising the sequence S-Y-A-M-H (SEQ ID NO:68); a CDR2 comprisingthe sequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and aCDR3 comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P(SEQ ID NO:70); and

(b) a light chain immunoglobulin variable region segment comprising: aCDR1 comprising the sequence Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145); aCDR2 comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73).

In an embodiment, the antibody molecule comprises a heavy chainimmunoglobulin variable region segment that comprises SEQ ID NO: 25. Inan embodiment, the antibody molecule comprises a light chainimmunoglobulin variable region segment that comprises SEQ ID NO: 52. Inan embodiment, the antibody molecule comprises: a heavy chainimmunoglobulin variable region segment that comprises SEQ ID NO: 25 anda light chain immunoglobulin variable region segment that comprises SEQID NO: 52. In an embodiment, the antibody molecule comprises a tetramerof: two heavy chain immunoglobulin variable region segments, eachcomprising SEQ ID NO: 25 and two light chain immunoglobulin variableregion segments, each comprising SEQ ID NO: 52.

In an embodiment, the antibody molecule comprises a full lengthantibody. In an embodiment, the antibody molecule comprises a humanizedantibody molecule. In an embodiment, the antibody molecule comprises twoheavy claim variable regions and two light chain variable regions. In anembodiment, the antibody molecule is an IgG antibody. In an embodiment,the antibody molecule is a single chain antibody (scFv), a F(ab′)₂fragment, a Fab fragment, or an Fd fragment.

In an embodiment, the method further comprises administering to thesubject a second therapeutic agent, e.g., for influenza, or a disorderor symptom associated with influenza.

In an aspect, the disclosure features an anti-HA antibody moleculedescribed herein, e.g., Ab 044, of between 2 and 30 mg/kg, for use in amethod of treating a subject, e.g., a subject having influenza or atrisk for influenza. In an embodiment, the subject is treated forinfluenza or a disorder associated with influenza. In an embodiment, thetreatment comprises preventing the subject from influenza or a disorderassociated with influenza.

In an embodiment, the method comprises administering the anti-HAantibody to the subject in an amount between 10 and 15 mg/kg 1 to 15weeks prior to the expected date of an epidemic peak of influenza (or adisorder associated with influenza) in a region where the subjectresides. In another embodiment, the method comprises administering tothe subject an anti-HA antibody molecule in an amount between 11 and 16mg/kg.

In another aspect, the disclosure features an anti-HA antibody moleculedescribed herein, e.g., Ab 044, for use in a method of protecting apopulation of subjects, e.g., from influenza or a disorder associatedwith influenza, wherein the anti-HA antibody molecule is used in atleast 2%, at least 4%, at least 6%, at least 8%, or at least 10% of thesubjects in the population.

In one aspect, the disclosure features an anti-hemagglutinin (anti-HA)binding agent, e.g., a specific binding agent, e.g., an antibodymolecule, or preparation, or isolated preparation thereof, comprisingone or more or all of the following properties:

(a) it fails to produce any escape mutants as determined by the failureof a viral titer to recover following at least 10, 9, 8, 7, 6, or 5rounds of serial infections in cell culture with a mixture of theantibody molecule and an influenza A virus, e.g., a Group 1 strain,e.g., an H1N1 strain, e.g., A/South Carolina/1/1918, A/PuertoRico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004;

(b) it produces fewer escape mutants than does a reference anti-HAantibody molecule, e.g., Ab 67-11, FI6, FI28, C179, F10, CR9114, orCR6261, e.g., when tested by the method described in (a);

(c) it prevents infection by at least 1, 2, 3, 4 or 5 influenza subtypesof Group 1, and by at least 1, 2, 3, 4 or 5 influenza subtypes of Group2;

(d) it inhibits fusogenic activity of the targeted HA;

(e) it treats or prevents infection by a Group 1 virus, such as wherethe virus is an H1, H5, or H9 virus; and it treats or prevents infectionby a Group 2 virus, such as where the virus is an H3 or H7 virus;

(f) it treats or prevents infection by influenza A strains H1N1 andH3N2;

(g) it is effective for prevention or treatment of infection, e.g., inhumans or mice, with H1N1 and H3N2 when administered at 50 mg/kg, 25mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1mg/kg;

(h) it treats or prevents infection by influenza A H5N1 strains;

(i) it is effective for prevention or treatment of infection, e.g., inhumans or mice, with H5N1 when administered at 50 mg/kg, 25 mg/kg, 10mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg;

(j) the concentration of antibody molecule required for 50%neutralization of influenza A virus is less than 10 μg/mL;

(k) it treats or prevents infection by an influenza B virus, e.g.,B/Wisconsin/1/2010;

(l) it is effective for prevention or treatment of infection, e.g., inhumans or mice, with an influenza B virus, e.g., B/Wisconsin/1/2010,when administered at 10 mg/kg, 6 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1mg/kg;

(m) the concentration of antibody molecule required for 50%neutralization of influenza B virus, e.g., B/Wisconsin/1/2010, virus isless than 10 μg/mL;

(n) it prevents or minimizes secondary infection (e.g., secondarybacterial infection) or effects thereof on a subject;

(o) it is effective for preventing or minimizing secondary infection(e.g., secondary bacterial infection) or effects thereof on a subjectwhen administered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg;

(p) it binds an epitope which comprises or consists of the hemagglutinintrimer interface; and

(q) it binds an epitope other than that bound by a reference anti-HAantibody molecule, e.g., Ab 67-11, F16, F128, C179, F10, CR9114, orCR6261, e.g., as determined by structural analysis, e.g., by X-raycrystallography or NMR spectroscopy; or

(r) in an embodiment it binds to an epitope, e.g., it has an epitopethat overlaps with or is the same as, of an antibody disclosed herein,e.g., as determined by mutational analysis or crystal structureanalysis.

In one embodiment, the binding agent, e.g., an anti-HA antibodymolecule, has one or more of the following characteristics: the anti-HAantibody molecule prevents infection by at least 1, 2, 3, 4 or 5influenza subtypes of Group 1, and by at least 1, 2, 3, 4 or 5 influenzasubtypes of Group 2; the concentration of the anti-HA antibody moleculerequired for 50% neutralization of influenza A virus is less than 10μg/mL; or the anti-HA antibody molecule binds an epitope that comprisesor consists of the hemagglutinin trimer interface.

In one embodiment, the binding agent, e.g., an anti-HA antibodymolecule, featured in the disclosure treats or prevents infection by aGroup 1 virus, such as where the virus is an H1, H2, H5, H6, H8, H9,H12, H11, H13, H16, or H17 virus; and treats or prevents infection by aGroup 2 virus, such as where the virus is an H3, H4, H7, H10 or H15virus. In one embodiment, the binding agent, e.g., an anti-HA antibodymolecule, featured in the disclosure prevents infection by at least 1,2, 3, 4, 5, 6, 7, 8, 9, 10 or 11 influenza subtypes of Group 1, and byat least 1, 2, 3, 4, 5 or 6 influenza subtypes of Group 2. In oneembodiment, the binding agent, e.g., an anti-HA antibody molecule,featured in the disclosure treats or prevents infection by one or moreof H1N1, H2N2, H5N1, and H9N2, and also treats or prevents infection byone or more of H3N2 and H7N7. In an embodiment, a binding agent, e.g.,antibody molecule, binds, and in some embodiments, neutralizes: at leastone strain from the Group 1 H1, e.g., H1a or H1b, cluster and at leastone strain from the Group 2 H3 or H7 cluster. In an embodiment, abinding agent, e.g., antibody molecule, binds, and in some embodiments,neutralizes: at least one strain from the Group 1 H1, e.g., H1a or H1b,cluster and at least one influenza B strain, e.g., B/Wisconsin/1/2010.In an embodiment, a binding agent, e.g., antibody molecule, binds, andin certain embodiments, neutralizes: at least one strain from the Group2 H3 or H7 cluster and at least one influenza B strain, e.g.,B/Wisconsin/I/2010. In an embodiment, a binding agent, e.g., antibodymolecule, binds, and in certain embodiments, neutralizes: at least onestrain from the Group 1 H1, e.g., H1 a or H1b, cluster, at least onestrain from the Group 2 H3 or H7 cluster, and at least one influenza Bstrain, e.g., B/Wisconsin/1/2010. In one embodiment, the binding agent,e.g., an anti-HA antibody molecule, featured in the disclosure treats orprevents infection by one or more of influenza B viruses, e.g.,B/Wisconsin/1/2010.

In one embodiment, the anti-HA antibody molecule is not an anti-HAantibody molecule previously described in the art. For example, theanti-HA antibody molecule is other than one or more or all of Ab 67-11(U.S. Provisional Application No. 61/645,453), FI6 (FI6, as used herein,refers to any specifically disclosed F16 sequence in U.S. ApplicationPublication No. 2010/0080813, U.S. Application Publication No.2011/0274702, International Publication No. WO2013/011347, or Corti etal., Science 333:850-856, 2011, published online Jul. 28, 2011; FIGS.12A to 12C of International Publication No. WO2013/170139 or U.S.Application Publication No. 2013/0302349), FI28 (U.S. ApplicationPublication No. 2010/0080813), C179 (Okuno et al., J. Virol.67:2552-1558, 1993), F10 (Sui et al., Nat. Struct. Mol. Biol. 16:265,2009), CR9114 (Dreyfus et al., Science. 2012; 337(6100): 1343-1348;published online Aug. 9, 2012), or CR6261 (Ekiert et al., Science324:246-251, 2009; published online Feb. 26, 2009).

In one embodiment, the binding agent, e.g., an anti-HA antibodymolecule, neutralizes infection with H1N1 and H3N2 in vitro. In anotherembodiment, binding agent, e.g., an anti-HA antibody molecule,neutralizes infection with H1N1 and H3N2 in vivo. In one embodiment, thebinding agent, e.g., an anti-HA antibody molecule, neutralizes infectionwith H5N1 in vitro. In another embodiment, binding agent, e.g., ananti-HA antibody molecule, neutralizes infection with H5N1 in vivo. Inone embodiment, the binding agent, e.g., an anti-HA antibody molecule,neutralizes infection with an influenza B virus, e.g.,B/Wisconsin/1/2010, in vitro. In another embodiment, the binding agent,e.g., an anti-HA antibody molecule neutralizes infection with aninfluenza B virus, e.g., B/Wisconsin/1/2010, in vivo.

In another embodiment, the concentration of the binding agent, e.g., ananti-HA antibody molecule, required for 50% neutralization of influenzaA virus is 10 μg/mL or less, such as 9 μg/mL or less, 8 μg/mL or less, 7μg/mL or less, 6 μg/mL or less, or 5 μg/mL or less. In anotherembodiment, the concentration of the binding agent, e.g., an anti-HAantibody molecule, required for 60% neutralization of influenza A virus,50% neutralization of influenza A virus, or 40% neutralization ofinfluenza A virus is 10 μg/mL or less, such as 9 μg/mL or less, 8 μg/mLor less, 7 μg/mL or less, 6 μg/mL or less, or 5 μg/mL or less.

In yet another embodiment, the binding agent, e.g., an anti-HA antibodymolecule, is effective for prevention or treatment of infection, e.g.,in humans or mice, with H1N1 and H3N2, such as when administered at 50mg/kg, 25 mg/kg, 10 mg/kg, 6.0 mg/kg, 5.0 mg/kg, 4.0 mg/kg, 3.0 mg/kg,2.0 mg/kg, 1.0 mg/kg or less. In still another embodiment, the bindingagent, e.g., the anti-HA antibody molecule, is effective for preventionor treatment of infection, e.g., in humans or mice, with H5N1, such aswhen administered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6.0 mg/kg, 5.0 mg/kg,4.0 mg/kg, 3.0 mg/kg, 2.0 mg/kg, 1.0 mg/kg or less.

In another embodiment, a binding agent, e.g., an anti-HA antibodymolecule, is effective for the treatment or prevention of a Group 1virus, where the Group 1 virus is H1, H5, or H9, and in anotherembodiment, the binding agent, e.g., an anti-HA antibody molecule, iseffective for the treatment or prevention of a Group 2 virus, where theGroup 2 virus is H3 or H7. In another embodiment, the concentration ofthe binding agent, e.g., an anti-HA antibody molecule, required for 50%neutralization of influenza B virus, e.g., B/Wisconsin/1/2010, is 10μg/mL or less, such as 9 μg/mL or less, 8 μg/mL or less, 7 μg/mL orless, 6 μg/mL or less, or 5 μg/mL or less. In another embodiment, theconcentration of the binding agent, e.g., an anti-HA antibody molecule,required for 60% neutralization of influenza B virus, e.g.,B/Wisconsin/1/2010, 50% neutralization of influenza B virus, e.g.,B/Wisconsin/1/2010, or 40% neutralization of influenza B virus, e.g.,B/Wisconsin/1/2010, is 10 μg/mL or less, such as 9 μg/mL or less, 8μg/mL or less, 7 μg/mL or less, 6 μg/mL or less, or 5 μg/mL or less.

In another embodiment, the binding agent, e.g., an anti-HA antibodymolecule, is a full length tetrameric antibody, a single chain antibody(scFv), a F(ab′)₂ fragment, a Fab fragment, or an Fd fragment. Inanother embodiment, the heavy chain of the antibody molecule is a γ1heavy chain, and in yet another embodiment, the light chain of theantibody molecule is a κ light chain or a λ light chain. In yet anotherembodiment, the anti-HA antibody molecule featured in the disclosure isan IgG1 antibody.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties a)-f): a) itincludes one, two, or all of, H3 HA1 residues N38, 1278, and D291; b) itincludes H3 HA2 residue N12; c) it does not include one, two or all of,H3 HA1 residues Q327, T328, and R329; d) it does not include one, two,three, four, or all of, H3 HA2 residues G1, L2, F3, G4, and D46; e) itincludes one, two, or all of, H3 HA1 residues T318, R321, and V323; orf) it includes 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16,17, or all of, H3 HA2 residues A7, E11, I18, D19, G20, W21, L38, K39,T41, Q42, A43, I45, I48, N49, L52, N53, I56, and E57.

In an embodiment, the antibody molecule has properties: a) and b). In anembodiment, the antibody molecule has properties: c) and d). In anembodiment, the antibody molecule has properties: a); and c) or d). Inan embodiment, the antibody molecule has properties: b); and c) or d).In an embodiment, the antibody molecule has properties: c); and a) orb). In an embodiment, the antibody molecule has properties: d); and a)or b). In an embodiment, the antibody molecule has properties: a), b),c) and d). In an embodiment, the antibody molecule has properties: a),b), c), d), e), and f).

In an embodiment, the antibody molecule has a K_(D) for H3 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: a) H3 HA1 residuesN38, 1278, or D291; b) H3 HA2 residue N12; c) H3 HA1 residues T318,R321, or V323; or d) H3 HA2 residues A7, E11, I18, D19, G20, W21, L38,K39, T41, Q42, A43, I45, I48, N49, L52, N53, 156, or E57. In anembodiment, the antibody molecule has a K_(D) for H3 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: c) H3 HA1 residues Q327, T328, orR329; or d) H3 HA2 residues G1, L2, F3, G4, or D46.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties aa)-ff): aa)it includes one, two, or all of, H1 HA1 residues H31, N279, and S292;bb) it includes H1 HA2 residue G12; cc) it does not include one or bothof H1 HA1 residues Q328 and S329; dd) it does not include one, two,three, four, or all of, H1 HA2 residues G1, L2, F3, G4, and D46; ee) itincludes one, two, or all of, H1 HA1 residues T319, R322, and 1324 arebound by both Ab 044 and F16; or ff) it includes 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H1 HA2 residues A7, E11,I18, D19, G20, W21, Q38, K39, T41, Q42, N43, I45, I48, T49, V52, N53,156, and E57. In an embodiment, the antibody molecule has properties:aa) and bb). In an embodiment, the antibody molecule has properties: cc)and dd). In an embodiment, the antibody molecule has properties: aa);and cc) or dd). In an embodiment, the antibody molecule has properties:bb); and cc) or dd). In an embodiment, the antibody molecule hasproperties: cc); and aa) or bb). In an embodiment, the antibody moleculehas properties: dd); and aa) or bb). In an embodiment, the antibodymolecule has properties: aa), bb), cc) and dd). In an embodiment, theantibody molecule has properties: aa), bb), cc), dd), ee), and ff).

In an embodiment, the antibody molecule has a K_(D) for H1 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: aa) H1 HA1 residuesH31, N279, and S292; bb) H1 HA2 residue G12; cc) H1 HA1 residues T319,R322, and 1324; or dd) H1 HA2 residues A7, E11, I18, D19, G20, W21, Q38,K39, T41, Q42, N43, I45, I48, T49, V52, N53, 156, and E57. In anembodiment, the antibody molecule has a K_(D) for H1 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: cc) H1 HA1 residues Q328 and S329;or dd) H1 HA2 residues G1, L2, F3, G4, and D46. In an embodiment, theantibody molecule has one, two, three or all of the followingproperties: a) and aa); b) and bb); c) and cc); or d) and dd). In anembodiment, the molecule has properties c), cc), d), and dd).

In an embodiment, the binding agent, e.g., a specific binding agent,e.g., an antibody molecule, comprises one or both of: a heavy chainvariable region comprising at least, or more than, 60, 65, 70, 75, 80,85, 87, 90, 95, 98 or 99 percent homology with a heavy chain variableregion from Table 3, Table 4A, or Table 4B, or FIG. 2, FIG. 13 or FIG.17 of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; and a light chain variable regioncomprising at least, or more than, 60, 65, 70, 75, 80, 85, 87, 90, 95,98 or 99 percent homology with light chain variable region from Table 3,Table 4A, or Table 4B, or FIG. 3, FIG. 14 or FIG. 17 InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349.

In an embodiment, the antibody molecule comprises a heavy chain variableregion 25 (SEQ ID NO: 25), or a structurally or functionally relatedvariable heavy chain region as described herein. In an embodiment, theantibody molecule comprises a light chain variable region 52 (SEQ ID NO:52), 155 (SEQ ID NO: 155), or 45 (SEQ ID NO: 45), or a structurally orfunctionally related variable light chain region as described herein. Inan embodiment, the antibody molecule comprises: a heavy chain variableregion 25 (SEQ ID NO: 25), or a structurally or functionally relatedvariable heavy chain region as described herein; and a light chainvariable region 52 (SEQ ID NO: 52), 155 (SEQ ID NO: 155), or 45 (SEQ IDNO: 45), or a structurally or functionally related variable light chainregion as described herein.

In an embodiment, the antibody molecule comprises a heavy chain variableregion comprising one, two, or all of CDR1, CDR2, and CDR3, from heavychain variable region 25 (SEQ ID NO: 25), or a structurally orfunctionally related variable heavy chain region as described herein. Inan embodiment, the antibody molecule comprises a light chain variableregion comprising one, two, or all of CDR1, CDR2, and CDR3, from lightchain variable region 52 (SEQ ID NO: 52), 155 (SEQ ID NO: 155), or 45(SEQ ID NO: 45), or a structurally or functionally related sequence asdescribed herein. In an embodiment, the antibody molecule comprises: aheavy chain variable region comprising one, two, or all of CDR1, CDR2,and CDR3, from heavy chain variable region 25 (SEQ ID NO: 25), or astructurally or functionally related variable heavy chain region asdescribed herein; and a light chain variable region comprising one, two,or all of CDR1, CDR2, and CDR3, from light chain variable region 52 (SEQID NO: 52), 155 (SEQ ID NO: 155), or 45 (SEQ ID NO: 45), or astructurally or functionally related variable light chain region asdescribed herein.

In an embodiment, the antibody molecule comprises a heavy chain variableregion from FIG. 2 or FIG. 13 of International Publication No.WO2013/170139 or U.S. Application Publication No. 2013/0302349 or astructurally or functionally related variable heavy chain region asdescribed herein. In an embodiment, the antibody molecule comprises alight chain variable region from FIG. 3 or FIG. 14 of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349, or a structurally or functionally related variable lightchain region as described herein. In an embodiment, the antibodymolecule comprises one, two, or all of, a CDR1, CDR2, and CDR3 from aheavy chain variable region from FIG. 2 or FIG. 13 InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349, or a structurally or functionally related sequence asdescribed herein. In an embodiment, the antibody molecule comprises one,two, or all of, a CDR1, CDR2, and CDR3 from a light chain variableregion from FIG. 3 or FIG. 14 International Publication No.WO2013/170139 or U.S. Application Publication No. 2013/0302349, or astructurally or functionally related sequence as described herein. In anembodiment, the antibody molecule comprises one, two or all of, HC CDR1,HC CDR2, and HC CDR3 and one, two or all of, LC CDR1, LC CDR2, and LCCDR3 from an antibody disclosed in Table 3, or a structurally orfunctionally related sequence as described herein.

In another embodiment, the antibody molecule comprises the light chainLC45 (SEQ ID NO: 45). In yet another embodiment, the antibody comprisesthe light chain LC45, and the heavy chain HC25 (SEQ ID NO: 25) or 24(SEQ ID NO: 24). In one embodiment, the antibody molecule comprises thelight chain Ab032 (SEQ ID NO: 45) and the heavy chain 25 (SEQ ID NO:25). In yet another embodiment, the antibody molecule comprises lightchain LC52 (SEQ ID NO: 52) and heavy chain HC25 (SEQ ID NO: 25).

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from heavy chain disclosed herein. E.g.,the antibody molecule comprises one or more or all of FR1, FR2, FR3, orFR4, or FR sequences that differ individually, or collectively, by nomore than 1, 2, 3, 4, of 5 amino acid residues, e.g., conservativeresidues, from a heavy chain disclosed herein; and b) one or moreframework regions (FRs) from light chain disclosed herein. E.g., theantibody molecule comprises one or more or all of FR1, FR2, FR3, or FR4,or FR sequences that differ individually, or collectively, by no morethan 1, 2, 3, 4, of 5 amino acid residues, e.g., conservative residues,from light chain disclosed herein.

In one aspect, an anti-HA antibody molecule featured in the disclosure,or preparation, or isolated preparation thereof, comprises: (a) a heavychain immunoglobulin variable domain comprising a sequence at least 60,70, 80, 85, 87, 90, 95, 97, 98, or 99, e.g., 90%, homologous, to a heavychain consensus sequence provided herein, e.g., the heavy chainconsensus sequence provided in FIG. 2 or FIG. 13 of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349, e.g., the heavy chain consensus sequence provided in FIG.2 of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349, SEQ ID NO: 161; and (b) a light chainimmunoglobulin variable domain comprising a sequence at least 60, 70,80, 85, 87, 90, 95, 97, 98, or 99, e.g., 95%, homologous, to a lightchain consensus sequence provided herein, e.g., the light chainconsensus sequence provided in FIG. 3 or FIG. 14 of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349, e.g., the light chain consensus sequence provided in FIG.3 of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349, SEQ ID NO: 62.

For example, in one embodiment, the anti-HA antibody molecule featuredin the disclosure comprises one or both of: (a) a heavy chainimmunoglobulin variable domain comprising the sequence of SEQ ID NO:161, or a sequence at least 87% identical to SEQ ID NO: 161; and (b) alight chain immunoglobulin variable domain comprising the sequence SEQID NO: 62, or a sequence at least 95% identical to SEQ ID NO: 62.

In another embodiment the antibody molecule comprises: (a) a heavy chainimmunoglobulin variable domain comprising the sequence of SEQ ID NO:161, or a sequence at least 87% identical to SEQ ID NO: 161; and (b) alight chain immunoglobulin variable domain comprising the sequence SEQID NO:62, or a sequence at least 95% identical to SEQ ID NO: 62, whereinsaid antibody molecule: (i) fails to produce any escape mutants asdetermined by the failure of a viral titer to recover following at least10, 9, 8, 7, 6, or 5 rounds of serial infections in cell culture with amixture of the antibody molecule and an influenza virus (e.g., aninfluenza A virus, e.g., a Group 1 strain, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004, oran influenza B virus, e.g., B/Wisconsin/1/2010); and (ii) produces fewerescape mutants than does a reference anti-HA antibody molecule, e.g., Ab67-11, FI6, FI28, C179, F10, CR9114, or CR6261, such as when tested bythe method described in (i).

In an embodiment, the disclosure features an antibody moleculecomprising one or both of: (a) a heavy chain immunoglobulin variableregion comprising the sequence of SEQ ID NO: 161, or a sequence thatdiffers from SEQ ID NO:161 by not more than 1, 2, 3, 4, 5, 6, 8, 10, 11,12, 13, 14, 15 or 16, e.g., by no more than 2, 3, 4, or 5 amino acids,e.g., conservative amino acids; and (b) a light chain immunoglobulinvariable domain comprising the sequence SEQ ID NO:62, or a sequence thatdiffers from SEQ ID NO:62 that differs by no more than 1, 2, 3, 4 or 5amino acids, e.g., conservative amino acids.

In one embodiment, the 1, 2, 3, 4, 5, 6, 8, 10, 11, 12, 13, 14, 15 or 16amino acid differences, e.g., conservative amino acid differences, inthe heavy chain immunoglobulin variable region are in the FR regions ofthe heavy chain immunoglobulin variable domain. In another embodiment,the 1, 2, 3, 4 or 5 amino acid differences, e.g., conservative aminoacid differences, in the light chain immunoglobulin variable domain arein the FR regions of the light chain immunoglobulin variable domain. Inone embodiment, the amino acid differences in the heavy chainimmunoglobulin variable region, or in the light chain immunoglobulinvariable region, are conservative amino acid changes.

In an embodiment, the binding agent, e.g., an antibody molecule, bindsto an epitope, e.g., it has an epitope that overlaps with or is the sameas, of an antibody disclosed herein, e.g., as determined by mutationalanalysis or crystal structure analysis.

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from heavy chain consensus sequencedisclosed herein. e.g., the antibody molecule comprises one or more orall of FR1, FR2, FR3, or FR4, or sequences that differ individually, orcollectively, by no more than 1, 2, 3, 4, of 5 amino acid residues,e.g., conservative residues, from heavy chain consensus sequencedisclosed herein; and b) one or more framework regions (FRs) from lightchain consensus sequence disclosed herein. e.g., the antibody moleculecomprises one or more or all of FR1, FR2, FR3, or FR4, or sequences thatdiffer individually, or collectively, by no more than 1, 2, 3, 4, of 5amino acid residues, e.g., conservative residues, from light chainconsensus disclosed herein. In an embodiment, the binding agent, e.g.,an antibody molecule, specifically binds the HA antigen.

In another aspect, the disclosure features, a binding agent, e.g., anantibody molecule, or preparation, or isolated preparation thereof,comprising a structural or functional property of Ab 044.

In an embodiment, the antibody molecule competes with a referenceantibody molecule, e.g., an antibody molecule described herein, forbinding to a substrate, e.g., an HA. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising: a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 25; and (ii) a light chain variableregion segment comprising SEQ ID NO:52; or c) Ab 044.

The HA can be from a Group 1 strain, e.g., an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004.Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecules or the reference antibody molecule to decreasebinding of the other to a substrate, e.g., HA, e.g., HA1 or HA5, e.g.from an H1N1 strain, e.g., A/South Carolina/1/1918, A/PuertoRico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004. Reduction of the ability tobind can be evaluated by methods in the art. Reduction of the ability tobind can be evaluated, e.g., by one or more of: a) Biacore analysis; b)ELISA assay; and c) flow cytometry.

The antibody molecule can compete with the reference antibody such thatbinding of the reference antibody is decreased by 50% or more. In anembodiment, the antibody molecule binds to the same epitope, or aportion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule does not bind to the same epitope, ora portion thereof, which the reference antibody molecule binds.

In an embodiment, the antibody molecule binds to the same epitope, or aportion thereof, on HA, as does a reference antibody molecule, e.g. anantibody molecule disclosed herein. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising: a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 25; and (ii) a light chain variableregion segment comprising SEQ ID NO:52; or c) Ab 044.

The HA can be HA1 or HA5, e.g., from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004Binding tothe same epitope, or a portion thereof, can be shown by one or more of:a) mutational analysis, e.g., binding to HA, or binding affinity for HA,is decreased or abolished if a residue is mutated; b) analysis, e.g.,comparison, of the crystal structure of the antibody molecule and HA andthe crystal structure of a reference antibody and HA, e.g., to determinethe touch points of each; c) competition of the two antibodies forbinding to HA, e.g., HA1 or HA5, from, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004; andd) (c) and one or both of (a) and (b).

Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, from, e.g., anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;or c) flow cytometry.

The antibody molecule can compete with the reference antibody such thatbinding of the reference antibody is decreased by 50% or more. In anembodiment, the binding agent, e.g., an antibody molecule, comprises oneor both of: a heavy chain variable region comprising at least 60, 70,80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 25; and alight chain variable region comprising at least 60, 70, 80, 85, 90, 95,98 or 99 percent homology with SEQ ID NO: 52.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising atleast 60, 70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO:25; and a light chain variable region comprising at least 60, 70, 80,85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 52, wherein, eachHC CDR differs by no more than 1, 2, 3, 4 or 5 amino acids, e.g., 1 or2, e.g., conservative amino acids, from the corresponding CDR of SEQ IDNO: 25 and each LC CDR differs by no more than 1, 2, 3, 4 or 5 aminoacids, e.g., 1 or 2, e.g., conservative amino acids, from thecorresponding CDR of SEQ ID NO: 52.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising atleast 60, 70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO:25; and a light chain variable region comprising at least 60, 70, 80,85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 52, wherein theantibody molecule comprises 1, 2, 3, 4, 5, or all of: (i) a HC CDR1comprising: S at the 1st position and A at the 3rd position in HC CDR1;(ii) a HC CDR2 comprising one or both, e.g., one of: V at the 2^(nd)position; or N at the 7^(th) position and Q at the 16^(th) position inHC CDR2; (iii) a HC CDR3 comprising: R at the 3rd position (andoptionally, L at the 3^(rd) position); (iv) a LC CDR1 comprising one orboth of, e.g., one of: I at the 3rd position; or D at the 6th positionin LC CDR1; (v) a LC CDR2 comprising one, two, or three of, e.g., oneof: G at the 2^(nd) position; Y at the 4^(th) position; or L at the5^(th) position in LC CDR2; (vi) a LC CDR3 comprising: S at the 9^(th)position in LC CDR3.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises: (a) a heavy chain immunoglobulin variable region segmentcomprising SEQ ID NO:25 (or a sequence that differs by no more than 1,2, 3, 4 or 5 amino acids, e.g., conservative amino acids, therefrom);and (b) a light chain variable region segment comprising SEQ ID NO:52(or a sequence that differs by no more than 1, 2, 3, 4 or 5 amino acids,e.g., conservative amino acids, therefrom).

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: (a) a heavy chain immunoglobulin variableregion segment comprising: a CDR1 comprising the sequence S-Y-A-M-H (SEQID NO:68) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom); aCDR2 comprising the sequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ IDNO:69) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom); aCDR3 comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P(SEQ ID NO:70) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2 amino acids, e.g., conservative amino acids,therefrom); and (b) a light chain variable region segment comprising: aCDR1 comprising the sequence: Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145)(or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1or 2 amino acids, e.g., conservative amino acids, therefrom); a CDR2comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom); a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequence that differs byno more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom).

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a) LC CDR1-3, that collectively, differ fromthe AB 044 LC CDR1-3 by no more than, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10,e.g., 1, 2, 3, or 4, amino acids, e.g., conservative amino acids; and b)HC CDR1-3, that collectively, differ from the AB 044 HC CDR1-3 by nomore than, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., 1, 2, 3, or 4, aminoacids, e.g., conservative amino acids.

In one embodiment, the antibody molecule comprises one or both of: (a) aheavy chain immunoglobulin variable region segment comprising SEQ ID NO:25; and (b) a light chain variable region segment comprising SEQ ID NO:52.

In an embodiment, the binding agent is an antibody molecule comprisingone or both of: (a) a heavy chain immunoglobulin variable region segmentcomprising: a CDR1 comprising the sequence S-Y-A-M-H (SEQ ID NO:68) (ora sequence that differs by no more than, 1, 2, or 3, e.g., 1 or 2, aminoacids, e.g., conservative amino acids, there from, optionally providedthat at least 1 or 2 of the highlighted residue are not changed, e.g.,both S and A are not changed); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom, optionally provided that atleast 1, 2, or 3 of the highlighted residues are not changed, e.g., V orboth N and Q or all three of V, N, and Q are not changed); a CDR3comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ IDNO:70) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom,optionally provided that R is not changed); and (b) a light chainvariable region segment comprising: a CDR1 comprising the sequence:Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145) (or a sequence that differs byno more than, 1, 2, 3, 4, or 5, e.g., 1 or 2, amino acids, e.g.,conservative amino acids, therefrom, optionally provided that at least 1or 2 of the highlighted residues are not changed, e.g., I or D is notchanged); a CDR2 comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72)(or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1or 2, amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that at least 1, 2 or 3 of the highlighted residues are notchanged, e.g., 1, 2 or all of G, Y, and L are not changed); a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequencethat differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2, aminoacids, e.g., conservative amino acids, therefrom, optionally providedthat at least 1 or both of the highlighted residues are not changed,e.g., S is not changed). In an embodiment a CDR of the light or heavychain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR, (i.e., while otherresidues in that CDR might be changed, the highlighted residue orcombination of residues, are not changed). E.g., in an embodiment, V orboth N and Q, for heavy chain CDR2 are not changed.

In an embodiment, a CDR of the light and a CDR of the heavy chain eachincludes one of the highlighted residues, or one of the highlightedcombinations of residues, for that CDR. In an embodiment each of twoCDRs in the antibody molecule includes one of the highlighted residues,or one of the highlighted combinations of residues, for that CDR. Insome embodiments, both are in the light chain. In some embodiments, bothare in the heavy chain. In an embodiment each of the three CDRs in theheavy chain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR. In an embodimenteach of the three CDRs in the light chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that CDR. In an embodiment each of the six CDRs in theheavy and light chain includes one of the highlighted residues, or oneof the highlighted combinations of residues, for that CDR.

In one embodiment, the binding agent is an antibody molecule thatcomprises one or more or all of the following properties: (a) both S andA in HC CDR1 are unchanged; (b) V or both N and Q or all three of V, N,and Q in HC CDR2 are unchanged; (c) R in HC CDR3 is unchanged; (d) Oneor both of I and D in LC CDR1 are unchanged. (e) 1, 2 or 3 of G, Y and Lin LC CDR2 are unchanged; or (f) S in LC CDR3 is unchanged. In anembodiment, the antibody molecule comprises 1, 2, 3, 4, 5, or all 6properties selected from (a) to (f). In an embodiment, the antibodymolecule comprises a heavy chain having a one or more propertiesselected from (a), (b), and (c) and a light chain having one or moreproperties selected from (d), (e), and (f).

In one embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: (a) a heavy chain immunoglobulin variableregion segment comprising: a CDR1 comprising the sequence S-Y-A-M-H (SEQID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); a CDR3 comprising thesequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); and (b)a light chain variable region segment comprising: a CDR1 comprising thesequence Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ ID NO: 145); a CDR2 comprising thesequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P—P-S (SEQ ID NO:73).

In some embodiments, the antibody molecule comprises one or more or allof the following properties: (i) it fails to produce any escape mutantsas determined by the failure of a viral titer to recover following atleast 10, 9, 8, 7, 6, or 5 rounds of serial infections in cell culturewith a mixture of the antibody molecule and an influenza virus (e.g., aninfluenza A virus, e.g., a Group 1 strain, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004, oran influenza B virus, e.g., B/Wisconsin/1/2010); and (ii) it producesfewer escape mutants than does a reference anti-HA antibody molecule,such as Ab 67-11, F16, FI28, C179, F10, CR9114, or CR6261, such as whentested by the method described in (i).

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from SEQ ID NO: 25 e.g., the antibodymolecule comprises one or more or all of FR1, FR2, FR3, or FR4, orsequences that differ individually, or collectively, by no more than 1,2, 3, 4, of 5 amino acid residues, e.g., conservative residues, from SEQID NO: 25; and b) one or more framework regions (FRs) from SEQ ID NO:52. E.g., the antibody molecule comprises one or more or all of FR1,FR2, FR3, or FR4, or sequences that differ individually, orcollectively, by no more than 1, 2, 3, 4, of 5 amino acid residues,e.g., conservative residues, from SEQ ID NO: 52.

In one embodiment, the antibody molecule comprises: (a) a heavy chainimmunoglobulin variable region segment that further comprises one ormore or all of: an FR1 comprising the sequenceQ-V-Q-L-L-E-T-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ IDNO:74) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2, amino acids, e.g., conservative amino acids, therefrom,optionally provided that T is not changed); an FR2 comprising thesequence W-V-R-Q-P-P-G-K-G-L-E-W-V-A (SEQ ID NO:75) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2, amino acids,e.g., conservative amino acids, therefrom, optionally provided that W isnot changed, or that if changed, is other than R); an FR3 comprising thesequence R-F-T-I-S-R-D-N-S-K-N-T-L-Y-L-Q-M-N-S-L-R-A-E-D-T-A-V-Y-Y-C-A-K(SEQ ID NO:76) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2, amino acids, e.g., conservative amino acids,therefrom, optionally provided that one, two or three of I, R, or L isnot changed, or that if I is changed it is other than G, if R is changedit is other than P. or if L is changed it is other than A); and an FR4comprising the sequence W-G-Q-G-T-T-L-T-V-S-S (SEQ ID NO:77) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2,amino acids, e.g., conservative amino acids, therefrom) orW-G-Q-G-T-T-V-T-V-S-S (SEQ ID NO:171) (or a sequence that differs by nomore than, 1, 2, 3, 4, or 5, e.g., 1 or 2, amino acids, e.g.,conservative amino acids, therefrom); and (b) a light chainimmunoglobulin variable region segment comprising one or more or all of:an FR1 comprising the sequenceD-I-Q-M-T-Q-S-P-S-S-L-S-A-S-V-G-D-R-V-T-I-T-C-R-S-S (SEQ ID NO:78) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2,amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that R is not changed); an FR2 comprising the sequenceW-Y-Q-Q-K-P-G-K-A-P-K-L-L-I-Y (SEQ ID NO:79) (or a sequence that differsby no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom); an FR3 comprising the sequenceG-V-P-S-R-F-S-G-S-G-S-G-T-D-F-T-L-T-I-S-S-L-Q-P-E-D-F-A-T-Y-Y-C (SEQ IDNO:80) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom,optionally provided that C is not changed, or if changed, is other thanP); and an FR4 comprising the sequence F-G-Q-G-T-K-V-E-I-K (SEQ IDNO:81) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom). Inan embodiment a FR of the light or heavy chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that FR, (i.e., while other residues in that FR might bechanged, the highlighted residue or combination of residues, are notchanged). E.g., in an embodiment, one, two or three of I, R, or L forheavy chain FR3 is not changed.

In an embodiment, a FR of the light and a FR of the heavy chain eachincludes one of the highlighted residues, or one of the highlightedcombinations of residues, for that FR. In an embodiment each of two FRsin the antibody molecule includes one of the highlighted residues, orone of the highlighted combinations of residues, for that FR. In someembodiments, both are in the light chain. In some embodiments, both arein the heavy chain. In an embodiment each of FR2 and FR3 in the heavychain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that FR. In an embodiment eachof FR1 and FR2 in the heavy and light chain includes one of thehighlighted residues for that FR. In an embodiment all of thehighlighted residues in heavy chain FR1-4 are unchanged. In anembodiment all of the highlighted residues in light chain FR1-4 areunchanged. In an embodiment all of the highlighted residues in bothheavy and light chain FR1-4 are unchanged. In an embodiment, sequence ofFR1 of the heavy chain variable region segment isQ-V-Q-L-L-E-T-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ ID NO:74). In an embodiment, sequence of FR1 of the heavy chain variableregion segment isE-V-Q-L-L-E-S-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ ID NO:173).

In another embodiment, the binding agent, e.g., an antibody molecule,comprises one or more or all of the following properties: (a) it failsto produce any escape mutants as determined by the failure of a viraltiter to recover following at least 10, 9, 8, 7, 6, or 5 rounds ofserial infections in cell culture with a mixture of the antibodymolecule and an influenza virus (e.g., an influenza A virus, e.g., aGroup 1 strain, e.g., an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004, or an influenza B virus,e.g., B/Wisconsin/1/2010); (b) it produces fewer escape mutants thandoes a reference anti-HA antibody molecule, e.g., Ab 67-11, FI6, FI28,C179, or CR6261, e.g., when tested by the method described in (a); (c)it binds with high affinity to a hemagglutinin (HA) of at least 1, 2, 3,4 or 5 influenza subtypes of Group 1 and at least 1, 2, 3, 4 or 5influenza subtypes of Group 2; (d) it treats or prevents infection by atleast 1, 2, 3, 4 or 5 influenza subtypes of Group 1, and by at least 1,2, 3, 4 or 5 influenza subtypes of Group 2; (e) it inhibits fusogenicactivity of the targeted HA; (f) it treats or prevents infection by aGroup 1 virus, wherein the virus is an H1, H5, or H9 virus; and treatsor prevents infection by a Group 2 virus, wherein the virus is an H3 orH7 virus; (g) it treats or prevents infection by influenza A strainsH1N1 and H3N2; (h) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with H1N1 and H3N2 when administeredat 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2mg/kg or 1 mg/kg; (i) it treats or prevents infection by influenza Astrains H5N1; (j) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with H5N1 when administered at 50mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kgor 1 mg/kg; (k) it binds with high affinity to a hemagglutinin (HA) ofan influenza B virus, e.g., B/Wisconsin/1/2010; (l) it treats orprevents infection by an influenza B virus, e.g., B/Wisconsin/1/2010;(m) it is effective for prevention or treatment of infection, e.g., inhumans or mice, with an influenza B virus, e.g., B/Wisconsin/1/2010 whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg or 1 mg/kg; (n) the concentration of antibody moleculerequired for 50% neutralization of influenza A virus is less than 10μg/mL; (o) the concentration of antibody molecule required for 50%neutralization of influenza B virus, e.g., B/Wisconsin/1/2010, is lessthan 10 μg/mL; (p) it prevents or minimizes secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject; (q) itis effective for preventing or minimizing secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg or 1 mg/kg; (r) it binds an epitope which comprises orconsists of the hemagglutinin trimer interface; and (s) it binds anepitope other than that bound by a reference anti-HA antibody molecule,e.g., Ab 67-11, F16, F128, C179, F10, CR9114, or CR6261, e.g., whentested by a method disclosed herein, e.g., by competition in an ELISAassay.

In an embodiment, the binding agent, e.g., an antibody molecule,specifically binds the HA antigen. In an embodiment, the antibodymolecule binds an epitope that has one, two, three, four, five, or allof, the following properties a)-f): a) it includes one, two, or all of,H3 HA1 residues N38, 1278, and D291; b) it includes H3 HA2 residue N12;c) it does not include one, two or all of, H3 HA1 residues Q327, T328,and R329; d) it does not include one, two, three, four, or all of, H3HA2 residues G1, L2, F3, G4, and D46; e) it includes one, two, or allof, H3 HA1 residues T318, R321, and V323; or f) it includes 1, 2, 3, 4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H3 HA2residues A7, E11, I18, D19, G20, W21, L38, K39, T41, Q42, A43, I45, I48,N49, L52, N53, I56, and E57.

In an embodiment, the antibody molecule has properties: a) and b). In anembodiment, the antibody molecule has properties: c) and d). In anembodiment, the antibody molecule has properties: a); and c) or d). Inan embodiment, the antibody molecule has properties: b); and c) or d).In an embodiment, the antibody molecule has properties: c); and a) orb). In an embodiment, the antibody molecule has properties: d); and a)or b). In an embodiment, the antibody molecule has properties: a), b),c) and d). In an embodiment, the antibody molecule has properties: a),b), c), d), e), and f).

In an embodiment, the antibody molecule has a K_(D) for H3 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: a) H3 HA1 residuesN38, 1278, or D291; b) H3 HA2 residue N12; c) H3 HA1 residues T318,R321, or V323; or d) H3 HA2 residues A7, E11, I18, D19, G20, W21, L38,K39, T41, Q42, A43, I45, I48, N49, L52, N53, 156, or E57. In anembodiment, the antibody molecule has a K_(D) for H3 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: c) H3 HA1 residues Q327, T328, orR329; or d) H3 HA2 residues G1, L2, F3, G4, or D46.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties aa)-ff): aa)it includes one, two, or all of, H1 HA1 residues H31, N279, and S292;bb) it includes H1 HA2 residue G12; cc) it does not include one or bothof H1 HA1 residues Q328 and S329; dd) it does not include one, two,three, four, or all of, H1 HA2 residues G1, L2, F3, G4, and D46; ee) itincludes one, two, or all of, H1 HA1 residues T319, R322, and 1324 arebound by both Ab 044 and FI6; or ff) it includes 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H1 HA2 residues A7, E11,I18, D19, G20, W21, Q38, K39, T41, Q42, N43, I45, I48, T49, V52, N53,156, and E57.

In an embodiment, the antibody molecule has properties: aa) and bb). Inan embodiment, the antibody molecule has properties: cc) and dd). In anembodiment, the antibody molecule has properties: aa); and cc) or dd).In an embodiment, the antibody molecule has properties: bb); and cc) ordd). In an embodiment, the antibody molecule has properties: cc); andaa) or bb). In an embodiment, the antibody molecule has properties: dd);and aa) or bb). In an embodiment, the antibody molecule has properties:aa), bb), cc) and dd). In an embodiment, the antibody molecule hasproperties: aa), bb), cc), dd), ee), and ff).

In an embodiment, the antibody molecule has a K_(D) for H1 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: aa) H1 HA1 residuesH31, N279, and S292; bb) H1 HA2 residue G12; cc) H1 HA1 residues T319,R322, and 1324; or dd) H1 HA2 residues A7, E11, I18, D19, G20, W21, Q38,K39, T41, Q42, N43, I45, I48, T49, V52, N53, 156, and E57. In anembodiment, the antibody molecule has a K_(D) for H1 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: cc) H1 HA1 residues Q328 and S329;or dd) H1 HA2 residues G1, L2, F3, G4, and D46.

In an embodiment, the antibody molecule has one, two, three or all ofthe following properties: a) and aa); b) and bb); c) and cc); d) anddd). In an embodiment, the molecule has properties c), cc), d), and dd).

In another aspect, the disclosure features, a binding agent, e.g., anantibody molecule, or preparation, or isolated preparation thereof,comprising a structural or functional property of Ab 069.

In an embodiment, the antibody molecule competes with a referenceantibody molecule, e.g., an antibody molecule described herein, forbinding to a substrate, e.g., an HA. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising: a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-E-Y-K-N-Y-L-A (SEQ ID NO: 172); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 25; and (ii) a light chain variableregion segment comprising SEQ ID NO:155; or c) Ab 069.

The HA can be HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004.Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, e.g. from anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;c) flow cytometry.

The antibody molecule can compete with the reference antibody such thatbinding of the reference antibody is decreased by 50% or more. In anembodiment, the antibody molecule binds to the same epitope, or aportion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule does not bind to the same epitope, ora portion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule binds to the same epitope, or aportion thereof, on HA, as does a reference antibody molecule, e.g. anantibody molecule disclosed herein. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising: a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-E-Y-K-N-Y-L-A (SEQ ID NO: 172); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P—P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 25; and (ii) a light chain variableregion segment comprising SEQ ID NO: 155; or c) Ab 069.

The HA can be HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004. Binding tothe same epitope, or a portion thereof, can be shown by one or more of:a) mutational analysis, e.g., binding or lack thereof to mutant HA,e.g., if a residue is mutated; b) analysis, e.g., comparison, of thecrystal structure of the antibody molecule and HA and the crystalstructure of a reference antibody and HA, e.g., to determine the touchpoints of each; c) competition of the two antibodies for binding to HA,e.g., HA1 or HA5, from, e.g., an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004; or d) (c)and one or both of (a) and (b);

Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, e.g. from anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;c) flow cytometry. The antibody molecule can compete with the referenceantibody such that binding of the reference antibody is decreased by 50%or more.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising atleast 60, 70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO:25; and a light chain variable region comprising at least 60, 70, 80,85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 155. In anembodiment, the binding agent, e.g., an antibody molecule, comprises oneor both of: a heavy chain variable region comprising at least 60, 70,80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 25; and alight chain variable region comprising at least 60, 70, 80, 85, 90, 95,98 or 99 percent homology with SEQ ID NO: 155, wherein each HC CDRdiffers by no more than 1, 2, 3, 4 or 5 amino acids, e.g., 1 or 2, e.g.,conservative amino acids, from the corresponding CDR of SEQ ID NO: 25and each LC CDR differs by no more than 1, 2, 3, 4 or 5 amino acids,e.g., 1 or 2, e.g., conservative amino acids, from the corresponding CDRof SEQ ID NO: 155. In an embodiment, the binding agent, e.g., anantibody molecule, comprises one or both of: a heavy chain variableregion comprising at least 60, 70, 80, 85, 90, 95, 98 or 99 percenthomology with SEQ ID NO: 25; and a light chain variable regioncomprising at least 60, 70, 80, 85, 90, 95, 98 or 99 percent homologywith SEQ ID NO: 155, wherein the antibody molecule comprises 1, 2, 3, 4,5, or all of: (i) a HC CDR1 comprising: S at the 1st position and A atthe 3rd position in HC CDR1; (ii) a HC CDR2 comprising one or both,e.g., one of: V at the 2nd position; or N at the 7^(th) position and Qat the 16^(th) position in HC CDR2; (iii) a HC CDR3 comprising: R at the3rd position (and optionally, L at the 3^(rd) position); (iv) a LC CDR1comprising one or both of, e.g., one of:; I at the 3rd position; or E atthe 6th position in LC CDR1; (v) a LC CDR2 comprising one, two or threeof, e.g., one of: G at the 2nd position; Y at the 4^(th) position; or Lat the 5^(th) position in LC CDR2; (vi) a LC CDR3 comprising: S at the9^(th) position in LC CDR3. In an embodiment, the binding agent, e.g.,an antibody molecule, comprises one or both of: (a) a heavy chainimmunoglobulin variable region segment comprising SEQ ID NO:25 (or asequence that differs by no more than 1, 2, 3, 4 or 5 amino acids, e.g.,conservative amino acids, therefrom); and (b) a light chain variableregion segment comprising SEQ ID NO:155 (or a sequence that differs byno more than 1, 2, 3, 4 or 5 amino acids, e.g., conservative aminoacids, therefrom). In one embodiment, the antibody molecule comprisesone or both of: (a) a heavy chain immunoglobulin variable region segmentcomprising SEQ ID NO: 25; and (b) a light chain variable region segmentcomprising SEQ ID NO: 155.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: (a) a heavy chain immunoglobulin variableregion segment comprising: a CDR1 comprising the sequence S-Y-A-M-H (SEQID NO:68) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom); aCDR2 comprising the sequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ IDNO:69) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom); aCDR3 comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P(SEQ ID NO:70) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2 amino acids, e.g., conservative amino acids,therefrom); and (b) a light chain variable region segment comprising: aCDR1 comprising the sequence: Q-S-I-T-F-E-Y-K-N-Y-L-A (SEQ ID NO: 172)or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or2 amino acids, e.g., conservative amino acids, therefrom); a CDR2comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom); a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequence that differs byno more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom).

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a) LC CDR1-3, that collectively, differ fromthe AB 069 LC CDR1-3 by no more than, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10,e.g., 1, 2, 3, or 4, amino acids, e.g., conservative amino acids; and b)HC CDR1-3, that collectively, differ from the AB 069 HC CDR1-3 by nomore than, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., 1, 2, 3, or 4, aminoacids, e.g., conservative amino acids.

In an embodiment, the binding agent is an antibody molecule comprisingone or both of: (a) a heavy chain immunoglobulin variable region segmentcomprising: a CDR1 comprising the sequence S-Y-A-M-H (SEQ ID NO:68) (ora sequence that differs by no more than, 1, 2, or 3, e.g., 1 or 2 aminoacids, e.g., conservative amino acids, therefrom, optionally providedthat at least 1 or 2 of the highlighted residues are not changed, e.g.,both S and A are not changed); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom, optionally provided that atleast 1, 2, or 3 of the highlighted residues are not changed, e.g., V orboth N and Q or all three of V, N, and Q are not changed); a CDR3comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ IDNO:70) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefromoptionally provided that, R is not changed); and (b) a light chainvariable region segment comprising: a CDR1 comprising the sequence:Q-S-I-T-F-E-Y-K-N-Y-L-A (SEQ ID NO: 172) or a sequence that differs byno more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom, optionally provided that at least 1or 2 of the highlighted residues are not changed, e.g., I or E is notchanged); a CDR2 comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72)(or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1or 2 amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that at least 1, 2, or 3 of the highlighted residues are notchanged, e.g., 1, 2 or all of G, Y, and L are not changed); a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequencethat differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 aminoacids, e.g., conservative amino acids, therefrom, optionally providedthat, at least one or both of the highlighted residues are not changed,e.g., S is not changed).

In an embodiment, a CDR of the light or heavy chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that CDR, (i.e., while other residues in that CDR might bechanged, the highlighted residue or combination of residues, are notchanged). In an embodiment a CDR of the light and a CDR of the heavychain each includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR. In an embodiment,each of two CDRs in the antibody molecule includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that CDR. In some embodiments, both are in the lightchain. In some embodiments, both are in the heavy chain. In anembodiment, each of the three CDRs in the heavy chain includes one ofthe highlighted residues, or one of the highlighted combinations ofresidues, for that CDR. In an embodiment, each of the three CDRs in thelight chain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR. In an embodiment,each of the six CDRs in the heavy and light chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that CDR.

In one embodiment, the binding agent is an antibody molecule thatcomprises one or more or all of the following properties: (a) both S andA in HC CDR1 are unchanged; (b) V or both N and Q or all three of V, N,and Q in HC CDR2 are unchanged; (c) R in HC CDR3 is unchanged; (d) oneor both of I and E in LC CDR1 are unchanged; (e) 1, 2 or 3 of G, Y and Lin LC CDR2 are unchanged; (f) S in LC CDR3 is unchanged. In anembodiment, the antibody molecule comprises 1, 2, 3, 4, 5, or all 6properties selected from (a) to (f). In an embodiment, the antibodymolecule comprises a heavy chain having a one or more propertiesselected from (a), (b), and (c) and a light chain having one or moreproperties selected from (d), (e), and (f). In one embodiment, theantibody molecule comprises one or both of: (a) a heavy chainimmunoglobulin variable region segment comprising: a CDR1 comprising thesequence S-Y-A-M-H (SEQ ID NO: 68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO: 69); a CDR3 comprising thesequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); and (b)a light chain variable region segment comprising: a CDR1 comprising thesequence Q-S-I-T-F-E-Y-K-N-Y-L-A (SEQ ID NO: 172); a CDR2 comprising thesequence W-G-S-Y-L-E-S (SEQ ID NO: 72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO: 73).

In some embodiments, the antibody molecule comprises one or more or allof the following properties: (i) it fails to produce any escape mutantsas determined by the failure of a viral titer to recover following atleast 10, 9, 8, 7, 6, or 5 rounds of serial infections in cell culturewith a mixture of the antibody molecule and an influenza virus (e.g., aninfluenza A virus, e.g., a Group 1 strain, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004, oran influenza B virus, e.g., B/Wisconsin/1/2010); and (ii) it producesfewer escape mutants than does a reference anti-HA antibody molecule,such as Ab 67-11, F16, FI28, C179, F10, CR9114, or CR6261, such as whentested by the method described in (i).

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from SEQ ID NO: 25, e.g., the antibodymolecule comprises one or more or all of FR1, FR2, FR3, or FR4, orsequences that differ individually, or collectively, by no more than 1,2, 3, 4, of 5 amino acid residues, e.g., conservative residues, from SEQID NO: 25; and b) one or more framework regions (FRs) from SEQ ID NO:155, e.g., the antibody molecule comprises one or more or all of FR1,FR2, FR3, or FR4, or sequences that differ individually, orcollectively, by no more than 1, 2, 3, 4, of 5 amino acid residues,e.g., conservative residues, from SEQ ID NO: 155.

In one embodiment, the antibody molecule comprises: (a) a heavy chainimmunoglobulin variable region segment that further comprises one ormore or all of: an FR1 comprising the sequenceQ-V-Q-L-L-E-T-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ IDNO:74) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2, amino acids, e.g., conservative amino acids, therefrom,optionally provided that T is not changed); an FR2 comprising thesequence W-V-R-Q-P-P-G-K-G-L-E-W-V-A (SEQ ID NO:75) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2, amino acids,e.g., conservative amino acids, therefrom, optionally provided that W isnot changed, or that if changed, is other than R); an FR3 comprising thesequence R-F-T-I-S-R-D-N-S-K-N-T-L-Y-L-Q-M-N-S-L-R-A-E-D-T-A-V-Y-Y-C-A-K(SEQ ID NO:76) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2, amino acids, e.g., conservative amino acids,therefrom, optionally provided that one, two or three of I, R, or L isnot changed, or that if I is changed it is other than G, if R is changedit is other than P. or if L is changed it is other than A); and (b) thelight chain immunoglobulin variable region segment comprises one or moreor all of: an FR1 comprising the sequenceD-I-Q-M-T-Q-S-P-S-S-L-S-A-S-V-G-D-R-V-T-I-T-C-R-S-S (SEQ ID NO:78) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that R is not changed); an FR2 comprising the sequenceW-Y-Q-Q-K-P-G-K-A-P-K-L-L-I-Y (SEQ ID NO:79) (or a sequence that differsby no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom); an FR3 comprising the sequenceG-V-P-S-R-F-S-G-S-G-S-G-T-D-F-T-L-T-I-S-S-L-Q-P-E-D-F-A-T-Y-Y-C (SEQ IDNO:80) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom,optionally provided that C is not changed, or if changed, is other thanP); and an FR4 comprising the sequence F-G-Q-G-T-K-V-E-I-K (SEQ IDNO:81) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom). Inan embodiment a FR of the light or heavy chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that FR, (i.e., while other residues in that FR might bechanged, the highlighted residue or combination of residues, are notchanged). E.g., in an embodiment, one, two or three of I, R, or L forheavy chain FR3 is not changed.

In an embodiment, a FR of the light and a FR of the heavy chain eachincludes one of the highlighted residues, or one of the highlightedcombinations of residues, for that FR. In an embodiment each of two FRsin the antibody molecule includes one of the highlighted residues, orone of the highlighted combinations of residues, for that FR. In someembodiments, both are in the light chain. In some embodiments, both arein the heavy chain. In an embodiment each of FR2 and FR3 in the heavychain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that FR. In an embodiment eachof FR1 and FR2 in the heavy and light chain includes one of thehighlighted residues for that FR. In an embodiment all of thehighlighted residues in heavy chain FR1-4 are unchanged. In anembodiment all of the highlighted residues in light chain FR1-4 areunchanged. In an embodiment all of the highlighted residues in bothheavy and light chain FR1-4 are unchanged.

In another embodiment, the binding agent, e.g., an antibody molecule,comprises one or more or all of the following properties: (a) it failsto produce any escape mutants as determined by the failure of a viraltiter to recover following at least 10, 9, 8, 7, 6, or 5 rounds ofserial infections in cell culture with a mixture of the antibodymolecule and an influenza virus (e.g., an influenza A virus, e.g., aGroup 1 strain, e.g., an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004, or an influenza B virus,e.g., B/Wisconsin/1/2010); (b) it produces fewer escape mutants thandoes a reference anti-HA antibody molecule, e.g., Ab 67-11, FI6, FI28,C179, or CR6261, e.g., when tested by the method described in (a); (c)it binds with high affinity to a hemagglutinin (HA) of at least 1, 2, 3,4 or 5 influenza subtypes of Group 1 and at least 1, 2, 3, 4 or 5influenza subtypes of Group 2; (d) it treats or prevents infection by atleast 1, 2, 3, 4 or 5 influenza subtypes of Group 1, and by at least 1,2, 3, 4 or 5 influenza subtypes of Group 2; (e) it inhibits fusogenicactivity of the targeted HA; (f) it treats or prevents infection by aGroup 1 virus, wherein the virus is an H1, H5, or H9 virus; and treatsor prevents infection by a Group 2 virus, wherein the virus is an H3 orH7 virus; (g) it treats or prevents infection by influenza A strainsH1N1 and H3N2; (h) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with H1N1 and H3N2 when administeredat 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2mg/kg or 1 mg/kg; (i) it treats or prevents infection by influenza Astrains H5N1; (j) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with H5N1 when administered at 50mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kgor 1 mg/kg; (k) it binds with high affinity to a hemagglutinin (HA) ofan influenza B virus, e.g., B/Wisconsin/1/2010; (l) it treats orprevents infection by an influenza B virus, e.g., B/Wisconsin/1/2010;(m) it is effective for prevention or treatment of infection, e.g., inhumans or mice, with an influenza B virus, e.g., B/Wisconsin/1/2010 whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg or 1 mg/kg; (n) the concentration of antibody moleculerequired for 50% neutralization of influenza A virus is less than 10μg/mL; (o) the concentration of antibody molecule required for 50%neutralization of influenza B virus, e.g., B/Wisconsin/1/2010, is lessthan 10 μg/mL; (p) it prevents or minimizes secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject; (q) itis effective for preventing or minimizing secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg or 1 mg/kg; (r) it binds an epitope which comprises orconsists of the hemagglutinin trimer interface; and (s) it binds anepitope other than that bound by a reference anti-HA antibody molecule,e.g., Ab 67-11, F16, F128, C179, F10, CR9114, or CR6261, e.g., whentested by a method disclosed herein, e.g., by competition in an ELISAassay.

In an embodiment, the binding agent, e.g., an antibody molecule,specifically binds the HA antigen. In an embodiment, the antibodymolecule binds an epitope that has one, two, three, four, five, or allof, the following properties a)-f): a) it includes one, two, or all of,H3 HA1 residues N38, 1278, and D291; b) it includes H3 HA2 residue N12;c) it does not include one, two or all of, H3 HA1 residues Q327, T328,and R329; d) it does not include one, two, three, four, or all of, H3HA2 residues G1, L2, F3, G4, and D46; e) it includes one, two, or allof, H3 HA1 residues T318, R321, and V323; or f) it includes 1, 2, 3, 4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H3 HA2residues A7, E11, I18, D19, G20, W21, L38, K39, T41, Q42, A43, I45, I48,N49, L52, N53, I56, and E57.

In an embodiment, the antibody molecule has properties: a) and b). In anembodiment, the antibody molecule has properties: c) and d). In anembodiment, the antibody molecule has properties: a); and c) or d). Inan embodiment, the antibody molecule has properties: b); and c) or d).In an embodiment, the antibody molecule has properties: c); and a) orb). In an embodiment, the antibody molecule has properties: d); and a)or b). In an embodiment, the antibody molecule has properties: a), b),c) and d). In an embodiment, the antibody molecule has properties: a),b), c), d), e), and f).

In an embodiment, the antibody molecule has a K_(D) for H3 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: a) H3 HA1 residuesN38, 1278, or D291; b) H3 HA2 residue N12; c) H3 HA1 residues T318,R321, or V323; or d) H3 HA2 residues A7, E11, I18, D19, G20, W21, L38,K39, T41, Q42, A43, I45, I48, N49, L52, N53, 156, or E57. In anembodiment, the antibody molecule has a K_(D) for H3 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: c) H3 HA1 residues Q327, T328, orR329; or d) H3 HA2 residues G1, L2, F3, G4, or D46.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties aa)-ff): aa)it includes one, two, or all of, H1 HA1 residues H31, N279, and S292;bb) it includes H1 HA2 residue G12; cc) it does not include one or bothof H1 HA1 residues Q328 and S329; dd) it does not include one, two,three, four, or all of, H1 HA2 residues G1, L2, F3, G4, and D46; ee) itincludes one, two, or all of, H1 HA1 residues T319, R322, and 1324 arebound by both Ab 044 and F16; or ff) it includes 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H1 HA2 residues A7, E11,I18, D19, G20, W21, Q38, K39, T41, Q42, N43, I45, I48, T49, V52, N53,156, and E57. In an embodiment, the antibody molecule has properties:aa) and bb). In an embodiment, the antibody molecule has properties: cc)and dd). In an embodiment, the antibody molecule has properties: aa);and cc) or dd). In an embodiment, the antibody molecule has properties:bb); and cc) or dd). In an embodiment, the antibody molecule hasproperties: cc); and aa) or bb). In an embodiment, the antibody moleculehas properties: dd); and aa) or bb). In an embodiment, the antibodymolecule has properties: aa), bb), cc) and dd). In an embodiment, theantibody molecule has properties: aa), bb), cc), dd), ee), and ff).

In an embodiment, the antibody molecule has a K_(D) for H1 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: aa) H1 HA1 residuesH31, N279, and S292; bb) H1 HA2 residue G12; cc) H1 HA1 residues T319,R322, and 1324; or dd) H1 HA2 residues A7, E11, I18, D19, G20, W21, Q38,K39, T41, Q42, N43, I45, I48, T49, V52, N53, 156, and E57. In anembodiment, the antibody molecule has a K_(D) for H1 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: cc) H1 HA1 residues Q328 and S329;or dd) H1 HA2 residues G1, L2, F3, G4, and D46;

In an embodiment, the antibody molecule has one, two, three or all ofthe following properties: a) and aa); b) and bb); c) and cc); d) anddd). In an embodiment, the molecule has properties c), cc), d), and dd).In an embodiment, the molecule has properties c), cc), d), and dd).

In another aspect, the disclosure features, a binding agent, e.g., anantibody molecule, or preparation, or isolated preparation thereof,comprising a structural or functional property of Ab 032.

In an embodiment, the antibody molecule competes with a referenceantibody molecule, e.g., an antibody molecule described herein, forbinding to a substrate, e.g., an HA. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising: a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-N-Y-K-N-Y-L-A (SEQ ID NO: 71); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO: 72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 25; and (ii) a light chain variableregion segment comprising SEQ ID NO: 45; or c) Ab 032.

The HA can be HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004.Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, e.g. from anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;and c) flow cytometry.

The antibody molecule can compete with the reference antibody such thatbinding of the reference antibody is decreased by 50% or more. In anembodiment, the antibody molecule binds to the same epitope, or aportion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule does not bind to the same epitope, ora portion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule binds to the same epitope, or aportion thereof, on HA, as does a reference antibody molecule, e.g. anantibody molecule disclosed herein. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-N-Y-K-N-Y-L-A (SEQ ID NO: 71); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P—P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 25; and (ii) a light chain variableregion segment comprising SEQ ID NO:45; or c) Ab 32.

The HA can be HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004. Binding tothe same epitope, or a portion thereof, can be shown by one or more of:a) mutational analysis, e.g., binding to HA, or binding affinity for HA,is decreased or abolished if a residue is mutated; b) analysis, e.g.,comparison, of the crystal structure of the antibody molecule and HA andthe crystal structure of a reference antibody and HA, e.g., to determinethe touch points of each; c) competition of the two antibodies forbinding to HA, e.g., HA1 or HA5, from, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004; andd) (c) and one or both of (a) and (b).

Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, from, e.g., anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;and c) flow cytometry. The antibody molecule can compete with thereference antibody such that binding of the reference antibody isdecreased by 50% or more.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising least60, 70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 25;and a light chain variable region comprising least 60, 70, 80, 85, 90,95, 98 or 99 percent homology with SEQ ID NO: 45. In an embodiment, thebinding agent, e.g., an antibody molecule, comprises one or both of: aheavy chain variable region comprising least 60, 70, 80, 85, 90, 95, 98or 99 percent homology with SEQ ID NO: 25; and a light chain variableregion comprising least 60, 70, 80, 85, 90, 95, 98 or 99 percenthomology with SEQ ID NO: 45, wherein each HC CDR differs by no more than1, 2, 3, 4 or 5 amino acids, e.g., 1 or 2, e.g., conservative aminoacids, from the corresponding CDR of SEQ ID NO: 25 and each LC CDRdiffers by no more than 1, 2, 3, 4 or 5 amino acids, e.g., 1 or 2, e.g.,conservative amino acids, from the corresponding CDR of SEQ ID NO: 45.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising least60, 70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 25;and a light chain variable region comprising least 60, 70, 80, 85, 90,95, 98 or 99 percent homology with SEQ ID NO: 45, wherein the antibodymolecule comprises 1, 2, 3, 4, 5, or all of: (i) a HC CDR1 comprising: Sat the 1st position and A at the 3rd position in HC CDR1; (ii) a HC CDR2comprising one or both, e.g., one of: V at the 2^(nd) position; or N atthe 7^(th) position and Q at the 16^(th) position in HC CDR2; (iii) a HCCDR3 comprising: R at the 3rd position (and optionally, L at the 3^(rd)position); (iv) a LC CDR1 comprising: I at the 3rd position; (v) a LCCDR2 comprising one, two, or three of, e.g., one of: G at the 2^(nd)position; Y at the 4^(th) position; or L at the 5^(th) position in LCCDR2; (vi) a LC CDR3 comprising: S at the 9^(th) position in LC CDR3; Inan embodiment, the binding agent, e.g., an antibody molecule, comprisesone or both of: (a) a heavy chain immunoglobulin variable region segmentcomprising SEQ ID NO:25 (or a sequence that differs by no more than 1,2, 3, 4 or 5 amino acids, e.g., conservative amino acids, therefrom);and (b) a light chain variable region segment comprising SEQ ID NO: 155(or a sequence that differs by no more than 1, 2, 3, 4 or 5 amino acids,e.g., conservative amino acids, therefrom).

In one embodiment, the antibody molecule comprises one or both of: (a) aheavy chain immunoglobulin variable region segment comprising SEQ ID NO:25; and (b) a light chain variable region segment comprising SEQ IDNO:155. In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: (a) a heavy chain immunoglobulin variableregion segment comprising a CDR1 comprising the sequence S-Y-A-M-H (SEQID NO:68) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom); aCDR2 comprising the sequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ IDNO:69) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom); aCDR3 comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P(SEQ ID NO:70) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2 amino acids, e.g., conservative amino acids,therefrom); and (b) a light chain variable region segment comprising aCDR1 comprising the sequence: Q-S-I-T-F N-Y-K-N-Y-L-A (SEQ ID NO:71) (ora sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom); a CDR2comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom); a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S(SEQ ID NO:73) (or a sequence that differs byno more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom). In an embodiment, the bindingagent, e.g., an antibody molecule, comprises one or both of: a) LCCDR1-3, that collectively, differ from the AB 032 LC CDR1-3 by no morethan, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., 1, 2, 3, or 4, aminoacids, e.g., conservative amino acids; and b) HC CDR1-3, thatcollectively, differ from the AB 032 HC CDR1-3 by no more than, 1, 2, 3,4, 5, 6, 7, 8, 9, or 10, e.g., 1, 2, 3, or 4, amino acids, e.g.,conservative amino acids. In an embodiment, the binding agent is anantibody molecule comprising one or both of: (a) a heavy chainimmunoglobulin variable region segment comprising a CDR1 comprising thesequence S-Y-A-M-H (SEQ ID NO:68) (or a sequence that differs by no morethan, 1, 2, or 3, e.g., 1 or 2 amino acids, e.g., conservative aminoacids, therefrom, optionally provided that at least 1 or 2 of thehighlighted residues are not changed, e.g., both S and A are notchanged); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom, provided that, e.g., at least1, 2, or 3 of the highlighted residues are not changed, e.g., V or bothN and Q or all three of V, N, and Q are not changed); a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70) (ora sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that R is not changed); and (b) a light chain variable regionsegment comprising a CDR1 comprising the sequence:Q-S-I-T-F-N-Y-K-N-Y-L-A (SEQ ID NO: 71) or a sequence that differs by nomore than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom, optionally provided that at least 1or 2 of the highlighted residues are not changed, e.g., I is notchanged); a CDR2 comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72)(or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1or 2 amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that at least 1, 2, or 3 of the highlighted residues are notchanged, e.g., 1, 2 or all of G, Y, and L are not changed); a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequencethat differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 aminoacids, e.g., conservative amino acids, therefrom, optionally providedthat at least one or both of the highlighted residues are not changed,e.g., S is not changed). In an embodiment a CDR of the light or heavychain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR, (i.e., while otherresidues in that CDR might be changed, the highlighted residue orcombination of residues, are not changed).

In an embodiment, a CDR of the light and a CDR of the heavy chain eachincludes one of the highlighted residues, or one of the highlightedcombinations of residues, for that CDR. In an embodiment each of twoCDRs in the antibody molecule includes one of the highlighted residues,or one of the highlighted combinations of residues, for that CDR. Insome embodiments, both are in the light chain. In some embodiments, bothare in the heavy chain. In an embodiment, each of the three CDRs in theheavy chain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR. In an embodiment,each of the three CDRs in the light chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that CDR. In an embodiment each of the six CDRs in theheavy and light chain includes one of the highlighted residues, or oneof the highlighted combinations of residues, for that CDR.

In one embodiment, the binding agent is an antibody molecule thatcomprises one or more or all of the following properties: (a) both S andA in HC CDR1 are unchanged. (b) V or both N and Q or all three of V, N,and Q in HC CDR2 are unchanged. (c) R in HC CDR3 is unchanged. (d) I inLC CDR1 is unchanged. (e) 1, 2 or 3 of G, Y and L in LC CDR2 areunchanged; (f) S in LC CDR3 is unchanged. In an embodiment, the antibodymolecule comprises 1, 2, 3, 4, 5, or all 6 properties selected from (a)to (f). In an embodiment, the antibody molecule comprises a heavy chainhaving a one or more properties selected from (a), (b), and (c) and alight chain having one or more properties selected from (d), (e), and(f).

In one embodiment, the antibody molecule comprises one or both of: (a) aheavy chain immunoglobulin variable region segment comprising: a CDR1comprising the sequence S-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising thesequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); a CDR3comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ IDNO:70); and (b) a light chain variable region segment comprising a CDR1comprising the sequence Q-S-I-T-F-N-Y-K-N-Y-L-A (SEQ ID NO: 71); a CDR2comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73).

In some embodiments, the antibody molecule comprises one or more or allof the following properties: (i) it fails to produce any escape mutantsas determined by the failure of a viral titer to recover following atleast 10, 9, 8, 7, 6, or 5 rounds of serial infections in cell culturewith a mixture of the antibody molecule and an influenza virus (e.g., aninfluenza A virus, e.g., a Group 1 strain, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004, oran influenza B virus, e.g., B/Wisconsin/1/2010); and (ii) it producesfewer escape mutants than does a reference anti-HA antibody molecule,such as Ab 67-11, F16, FI28, C179, F10, CR9114, or CR6261, such as whentested by the method described in (i).

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from SEQ ID NO: 25, e.g., the antibodymolecule comprises one or more or all of FR1, FR2, FR3, or FR4, orsequences that differ individually, or collectively, by no more than 1,2, 3, 4, of 5 amino acid residues, e.g., conservative residues, from SEQID NO: 25; and b) one or more framework regions (FRs) from SEQ ID NO:45, e.g., the antibody molecule comprises one or more or all of FR1,FR2, FR3, or FR4, or sequences that differ individually, orcollectively, by no more than 1, 2, 3, 4, of 5 amino acid residues,e.g., conservative residues, from SEQ ID NO: 45.

In one embodiment, the antibody molecule comprises: (a) a heavy chainimmunoglobulin variable region segment that further comprises one ormore or all of: an FR1 comprising the sequenceQ-V-Q-L-L-E-T-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ IDNO:74) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2, amino acids, e.g., conservative amino acids, therefrom,optionally provided that T is not changed); an FR2 comprising thesequence W-V-R-Q-P-P-G-K-G-L-E-W-V-A (SEQ ID NO:75) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2, amino acids,e.g., conservative amino acids, therefrom, optionally provided that W isnot changed, or that if changed, is other than R); an FR3 comprising thesequence R-F-T-I-S-R-D-N-S-K-N-T-L-Y-L-Q-M-N-S-L-R-A-E-D-T-A-V-Y-Y-C-A-K(SEQ ID NO:76) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2, amino acids, e.g., conservative amino acids,therefrom, optionally provided that one, two or three of I, R, or L isnot changed, or that if I is changed it is other than G, if R is changedit is other than P. or if L is changed it is other than A); and an FR4comprising the sequence W-G-Q-G-T-T-L-T-V-S-S (SEQ ID NO:77) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom) orW-G-Q-G-T-T-V-T-V-S-S (SEQ ID NO:171) (or a sequence that differs by nomore than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom); and (b) the light chainimmunoglobulin variable region segment comprises one or more or all of:an FR1 comprising the sequenceD-I-Q-M-T-Q-S-P-S-S-L-S-A-S-V-G-D-R-V-T-I-T-C-R-S-S (SEQ ID NO:78) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that R is not changed); an FR2 comprising the sequenceW-Y-Q-Q-K-P-G-K-A-P-K-L-L-I-Y (SEQ ID NO:79) (or a sequence that differsby no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom); an FR3 comprising the sequenceG-V-P-S-R-F-S-G-S-G-S-G-T-D-F-T-L-T-I-S-S-L-Q-P-E-D-F-A-T-Y-Y-C (SEQ IDNO:80) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom,optionally provided that C is not changed, or if changed, is other thanP); and an FR4 comprising the sequence F-G-Q-G-T-K-V-E-I-K (SEQ IDNO:81) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom). Inan embodiment a FR of the light or heavy chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that FR, (i.e., while other residues in that FR might bechanged, the highlighted residue or combination of residues, are notchanged). E.g., in an embodiment, one, two or three of I, R, or L forheavy chain FR3 is not changed.

In an embodiment, a FR of the light and a FR of the heavy chain eachincludes one of the highlighted residues, or one of the highlightedcombinations of residues, for that FR. In an embodiment, each of two FRsin the antibody molecule includes one of the highlighted residues, orone of the highlighted combinations of residues, for that FR. In someembodiments, both are in the light chain. In some embodiments, both arein the heavy chain. In an embodiment each of FR2 and FR3 in the heavychain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that FR. In an embodiment,each of FR1 and FR2 in the heavy and light chain includes one of thehighlighted residues for that FR. In an embodiment, all of thehighlighted residues in heavy chain FR1-4 are unchanged. In anembodiment, all of the highlighted residues in light chain FR1-4 areunchanged. In an embodiment all of the highlighted residues in bothheavy and light chain FR1-4 are unchanged.

In another embodiment, the binding agent, e.g., an antibody molecule,comprises one or more or all of the following properties: (a) it failsto produce any escape mutants as determined by the failure of a viraltiter to recover following at least 10, 9, 8, 7, 6, or 5 rounds ofserial infections in cell culture with a mixture of the antibodymolecule and an influenza virus (e.g., an influenza A virus, e.g., aGroup 1 strain, e.g., an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004, or an influenza B virus,e.g., B/Wisconsin/1/2010); (b) it produces fewer escape mutants thandoes a reference anti-HA antibody molecule, e.g., Ab 67-11, FI6, FI28,C179, or CR6261, e.g., when tested by the method described in (a); (c)it binds with high affinity to a hemagglutinin (HA) of at least 1, 2, 3,4 or 5 influenza subtypes of Group 1 and at least 1, 2, 3, 4 or 5influenza subtypes of Group 2; (d) it treats or prevents infection by atleast 1, 2, 3, 4 or 5 influenza subtypes of Group 1, and by at least 1,2, 3, 4 or 5 influenza subtypes of Group 2; (e) it inhibits fusogenicactivity of the targeted HA; (f) it treats or prevents infection by aGroup 1 virus, wherein the virus is an H1, H5, or H9 virus; and treatsor prevents infection by a Group 2 virus, wherein the virus is an H3 orH7 virus; (g) it treats or prevents infection by influenza A strainsH1N1 and H3N2; (h) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with H1N1 and H3N2 when administeredat 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2mg/kg or 1 mg/kg; (i) it treats or prevents infection by influenza Astrains H5N1; (j) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with H5N1 when administered at 50mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kgor 1 mg/kg; (k) it binds with high affinity to a hemagglutinin (HA) ofan influenza B virus, e.g., B/Wisconsin/1/2010; (l) it treats orprevents infection by an influenza B virus, e.g., B/Wisconsin/1/2010;(m) it is effective for prevention or treatment of infection, e.g., inhumans or mice, with an influenza B virus, e.g., B/Wisconsin/1/2010 whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg or 1 mg/kg; (n) the concentration of antibody moleculerequired for 50% neutralization of influenza A virus is less than 10μg/mL; (o) the concentration of antibody molecule required for 50%neutralization of influenza B virus, e.g., B/Wisconsin/1/2010, is lessthan 10 μg/mL; (p) it prevents or minimizes secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject; (q) itis effective for preventing or minimizing secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg or 1 mg/kg; (r) it binds an epitope which comprises orconsists of the hemagglutinin trimer interface; and (s) it binds anepitope other than that bound by a reference anti-HA antibody molecule,e.g., Ab 67-11, F16, F128, C179, F10, CR9114, or CR6261, e.g., whentested by a method disclosed herein, e.g., by competition in an ELISAassay.

In an embodiment, the binding agent, e.g., an antibody molecule,specifically binds the HA antigen. In an embodiment, the antibodymolecule binds an epitope that has one, two, three, four, five, or allof, the following properties a)-f): a) it includes one, two, or all of,H3 HA1 residues N38, 1278, and D291; b) it includes H3 HA2 residue N12;c) it does not include one, two or all of, H3 HA1 residues Q327, T328,and R329; d) it does not include one, two, three, four, or all of, H3HA2 residues G1, L2, F3, G4, and D46; e) it includes one, two, or allof, H3 HA1 residues T318, R321, and V323; or f) it includes 1, 2, 3, 4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H3 HA2residues A7, E11, I18, D19, G20, W21, L38, K39, T41, Q42, A43, I45, I48,N49, L52, N53, I56, and E57. In an embodiment, the antibody molecule hasproperties: a) and b). In an embodiment, the antibody molecule hasproperties: c) and d). In an embodiment, the antibody molecule hasproperties: a; and c or d. In an embodiment, the antibody molecule hasproperties: b); and c) or d). In an embodiment, the antibody moleculehas properties: c); and a) or b). In an embodiment, the antibodymolecule has properties: d); and a) or b). In an embodiment, theantibody molecule has properties: a), b), c) and d). In an embodiment,the antibody molecule has properties: a), b), c), d), e), and f). In anembodiment, the antibody molecule has a K_(D) for H3 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10, or 100fold, by a mutation or mutations in any of: a) H3 HA1 residues N38,1278, or D291; b) H3 HA2 residue N12; c) H3 HA1 residues T318, R321, orV323; or d) H3 HA2 residues A7, E11, I18, D19, G20, W21, L38, K39, T41,Q42, A43, I45, I48, N49, L52, N53, 156, or E57. In an embodiment, theantibody molecule has a K_(D) for H3 of equal to or less than 10⁻⁶,wherein said K_(D) is increased by no more than 2, or 5 fold, by amutation or mutations in any of: c) H3 HA1 residues Q327, T328, or R329;or d) H3 HA2 residues G1, L2, F3, G4, or D46.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties aa)-ff): aa)it includes one, two, or all of, H1 HA1 residues H31, N279, and S292;bb) it includes H1 HA2 residue G12; cc) it does not include one or bothof H1 HA1 residues Q328 and S329; dd) it does not include one, two,three, four, or all of, H1 HA2 residues G1, L2, F3, G4, and D46; ee) itincludes one, two, or all of, H1 HA1 residues T319, R322, and 1324 arebound by both Ab 044 and FI6; or ff) it includes 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H1 HA2 residues A7, E11,I18, D19, G20, W21, Q38, K39, T41, Q42, N43, I45, I48, T49, V52, N53,156, and E57.

In an embodiment, the antibody molecule has properties: aa) and bb). Inan embodiment, the antibody molecule has properties: cc) and dd). In anembodiment, the antibody molecule has properties: aa); and cc) or dd).In an embodiment, the antibody molecule has properties: bb); and c) ordd). In an embodiment, the antibody molecule has properties: cc); andaa) or bb). In an embodiment, the antibody molecule has properties: dd);and aa) or bb). In an embodiment, the antibody molecule has properties:aa), bb), cc) and dd). In an embodiment, the antibody molecule hasproperties: aa), bb), cc), dd), ee), and ff).

In an embodiment, the antibody molecule has a K_(D) for H1 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10,or 100 fold, by a mutation or mutations in any of: aa) H1 HA1 residuesH31, N279, and S292; bb) H1 HA2 residue G12; cc) H1 HA1 residues T319,R322, and 1324; or dd) H1 HA2 residues A7, E11, I18, D19, G20, W21, Q38,K39, T41, Q42, N43, I45, I48, T49, V52, N53, 156, and E57. In anembodiment, the antibody molecule has a K_(D) for H1 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: cc) H1 HA1 residues Q328 and S329;or dd) H1 HA2 residues G1, L2, F3, G4, and D46; In an embodiment, theantibody molecule has one, two, three or all of the followingproperties: a) and aa); b) and bb); c) and cc); d) and dd). In anembodiment, the molecule has properties c), cc), d), and dd).

In another aspect, the disclosure features, a binding agent, e.g., anantibody molecule, or preparation, or isolated preparation thereof,comprising a structural or functional property of Ab 031. In anembodiment, the antibody molecule competes with a reference antibodymolecule, e.g., an antibody molecule described herein, for binding to asubstrate, e.g., an HA. The reference antibody molecule can be:

a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F-N-Y-K—N-Y-L-A (SEQ ID NO:71); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 24; and (ii) a light chain variableregion segment comprising SEQ ID NO:45; or c) Ab 031. The HA can be HA1or HA5, e.g. from an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004. Competition between theantibody molecule and a reference antibody molecule can be determined byevaluating the ability of one of the antibody molecule or the referenceantibody molecule to decrease binding of the other to a substrate, e.g.,HA, e.g., HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004. Reductionof the ability to bind can be evaluated by methods in the art. Reductionof the ability to bind can be evaluated, e.g., by one or more of: a)Biacore analysis; b) ELISA assay; and c) flow cytometry. The antibodymolecule can compete with the reference antibody such that binding ofthe reference antibody is decreased by 50% or more.

In an embodiment, the antibody molecule binds to the same epitope, or aportion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule does not bind to the same epitope, ora portion thereof, which the reference antibody molecule binds. In anembodiment, the antibody molecule binds to the same epitope, or aportion thereof, on HA, as does a reference antibody molecule, e.g. anantibody molecule disclosed herein. The reference antibody molecule canbe: a) an antibody molecule comprising: i) a heavy chain immunoglobulinvariable region segment comprising a CDR1 comprising the sequenceS-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70); andii) a light chain variable region segment comprising: a CDR1 comprisingthe sequence Q-S-I-T-F—N—Y-K-N-Y-L-A (SEQ ID NO:71); a CDR2 comprisingthe sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73); b) an antibody moleculecomprises one or both of: (i) a heavy chain immunoglobulin variableregion segment comprising SEQ ID NO: 24; and (ii) a light chain variableregion segment comprising SEQ ID NO:45; or c) Ab 031. The HA can be HA1or HA5, e.g. from an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004. Binding to the same epitope,or a portion thereof, can be shown by one or more of: a) mutationalanalysis, e.g., binding to HA, or binding affinity for HA, is decreasedor abolished if a residue is mutated; b) analysis, e.g., comparison, ofthe crystal structure of the antibody molecule and HA and the crystalstructure of a reference antibody and HA, e.g., to determine the touchpoints of each; c) competition of the two antibodies for binding to HA,e.g., HA1 or HA5, from, e.g., an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004; d) (c) andone or both of (a) and (b).

Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, from, e.g., anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;and c) flow cytometry. The antibody molecule can compete with thereference antibody such that binding of the reference antibody isdecreased by 50% or more. In an embodiment, the binding agent, e.g., anantibody molecule, comprises one or both of: a heavy chain variableregion comprising least 60, 70, 80, 85, 90, 95, 98 or 99 percenthomology with SEQ ID NO: 24; and a light chain variable regioncomprising least 60, 70, 80, 85, 90, 95, 98 or 99 percent homology withSEQ ID NO: 45. In an embodiment, the binding agent, e.g., an antibodymolecule, comprises one or both of: a heavy chain variable regioncomprising least 60, 70, 80, 85, 90, 95, 98 or 99 percent homology withSEQ ID NO: 24; and a light chain variable region comprising least 60,70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 45,wherein, optionally, each HC CDR differs by no more than 1, 2, 3, 4 or 5amino acids, e.g., 1 or 2, e.g., conservative amino acids, from thecorresponding CDR of SEQ ID NO: 24 and each LC CDR differs by no morethan 1, 2, 3, 4 or 5 amino acids, e.g., 1 or 2, e.g., conservative aminoacids, from the corresponding CDR of SEQ ID NO: 45.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising least60, 70, 80, 85, 90, 95, 98 or 99 percent homology with SEQ ID NO: 25;and a light chain variable region comprising least 60, 70, 80, 85, 90,95, 98 or 99 percent homology with SEQ ID NO: 45, wherein the antibodymolecule comprises 1, 2, 3, 4, 5, or all of: (i) a HC CDR1 comprising: Sat the 1st position and A at the 3rd position in HC CDR1; (ii) a HC CDR2comprising one or both, e.g., one of: V at the 2nd position; or N at the7^(th) position and Q at the 16^(th) position in HC CDR2; (iii) a HCCDR3 comprising: R at the 3rd position (and optionally, L at the 3^(rd)position); (iv) a LC CDR1 comprising: I at the 3rd position; (v) a LCCDR2 comprising one, two, or three of, e.g., one of: G at the 2ndposition; Y at the 4^(th) position; or L at the 5^(th) position in LCCDR2; (vi) a LC CDR3 comprising: S at the 9^(th) position in LC CDR3.

In an embodiment, the binding agent comprises an antibody moleculecomprising: (a) a heavy chain immunoglobulin variable region segmentcomprising SEQ ID NO:24 (or a sequence that differs by no more than 1,2, 3, 4 or 5 amino acids, e.g., conservative amino acids, therefrom);and (b) a light chain variable region segment comprising SEQ ID NO:45(or a sequence that differs by no more than 1, 2, 3, 4 or 5 amino acids,e.g., conservative amino acids, therefrom). In one embodiment, theantibody molecule comprises one or both of: (a) a heavy chainimmunoglobulin variable region segment comprising SEQ ID NO: 24; and (b)a light chain variable region segment comprising SEQ ID NO:45. In anembodiment, the binding agent, e.g., an antibody molecule, comprises oneor both of: (a) a heavy chain immunoglobulin variable region segmentcomprising a CDR1 comprising the sequence S-Y-A-M-H (SEQ ID NO:68) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom); a CDR2comprising the sequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69)(or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1or 2 amino acids, e.g., conservative amino acids, therefrom); and a CDR3comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ IDNO:70) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom);and (b) a light chain variable region segment comprising a CDR1comprising the sequence Q-S-I-T-F-N-Y-K-N-Y-L-A (SEQ ID NO:71) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom); a CDR2comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO: 72) (or a sequencethat differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 aminoacids, e.g., conservative amino acids, therefrom); and a CDR3 comprisingthe sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom).

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a) LC CDR1-3, that collectively, differ fromthe AB 031 LC CDR1-3 by no more than, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10,e.g., 1, 2, 3, or 4, amino acids, e.g., conservative amino acids; and b)HC CDR1-3, that collectively, differ from the AB 031 HC CDR1-3 by nomore than, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, e.g., 1, 2, 3, or 4, aminoacids, e.g., conservative amino acids. In an embodiment, the bindingagent, e.g., an antibody molecule, comprises one or both of: (a) a heavychain immunoglobulin variable region segment comprising a CDR1comprising the sequence S-Y-A-M-H (SEQ ID NO:68) (or a sequence thatdiffers by no more than, 1, 2, or 3, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom, optionally provided that at least 1or 2 of the highlighted residues are not changed, e.g., both S and A arenot changed); a CDR2 comprising the sequenceV-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom, provided that, e.g., at least1, 2, or 3 of the highlighted residues are not changed, e.g., V or bothN and Q or all three of V, N, and Q are not changed); a CDR3 comprisingthe sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70) (ora sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom optionallyprovided that, e.g., R is not changed); and (b) a light chain variableregion segment comprising a CDR1 comprising the sequenceQ-S-I-T-F-N-Y-K—N-Y-L-A (SEQ ID NO: 71) or a sequence that differs by nomore than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom, optionally provided that at least 1or 2 of the highlighted residues are not changed, e.g., I is notchanged); a CDR2 comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72)(or a sequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1or 2 amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that at least 1, 2, or 3 of the highlighted residues are notchanged, e.g., 1, 2 or all of G, Y, and L are not changed); a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) (or a sequencethat differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 aminoacids, e.g., conservative amino acids, therefrom, optionally providedthat at least one or both of the highlighted residues are not changed,e.g., S is not changed). In an embodiment a CDR of the light or heavychain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR, (i.e., while otherresidues in that CDR might be changed, the highlighted residue orcombination of residues, are not changed).

In an embodiment a CDR of the light and a CDR of the heavy chain eachincludes one of the highlighted residues, or one of the highlightedcombinations of residues, for that CDR. In an embodiment each of twoCDRs in the antibody molecule includes one of the highlighted residues,or one of the highlighted combinations of residues, for that CDR. Insome embodiments, both are in the light chain. In some embodiments, bothare in the heavy chain. In an embodiment each of the three CDRs in theheavy chain includes one of the highlighted residues, or one of thehighlighted combinations of residues, for that CDR. In an embodimenteach of the three CDRs in the light chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that CDR. In an embodiment each of the six CDRs in theheavy and light chain includes one of the highlighted residues, or oneof the highlighted combinations of residues, for that CDR.

In one embodiment, the binding agent is an antibody molecule thatcomprises one or more or all of the following properties: (a) both S andA in HC CDR1 are unchanged; (b) V or both N and Q or all three of V, N,and Q in HC CDR2 are unchanged; (c) R in HC CDR3 is unchanged; (d) I inLC CDR1 is unchanged; (e) 1, 2 or 3 of G, Y, and L in LC CDR2 areunchanged; (f) S in LC CDR3 is unchanged. In an embodiment, the antibodymolecule comprises 1, 2, 3, 4, 5, or all 6 properties selected from (a)to (f). In an embodiment, the antibody molecule comprises a heavy chainhaving a one or more properties selected from (a), (b), and (c) and alight chain having one or more properties selected from (d), (e), and(f).

In the embodiment, the antibody molecule comprises one or both of: (a) aheavy chain immunoglobulin variable region segment comprising: a CDR1comprising the sequence S-Y-A-M-H (SEQ ID NO:68); a CDR2 comprising thesequence V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69); and a CDR3comprising the sequence D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ IDNO:70); and (b) a light chain variable region segment comprising a CDR1comprising the sequence Q-S-I-T-F-N-Y-K-N-Y-L-A (SEQ ID NO:71); a CDR2comprising the sequence W-G-S-Y-L-E-S (SEQ ID NO:72); and a CDR3comprising the sequence Q-Q-H-Y-R-T-P-P-S (SEQ ID NO:73). In someembodiments, the antibody molecule comprises one or more or all of thefollowing properties: (i) it fails to produce any escape mutants asdetermined by the failure of a viral titer to recover following at least10, 9, 8, 7, 6, or 5 rounds of serial infections in cell culture with amixture of the antibody molecule and an influenza virus (e.g., aninfluenza A virus, e.g., a Group 1 strain, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004, oran influenza B virus, e.g., B/Wisconsin/1/2010); and (ii) it producesfewer escape mutants than does a reference anti-HA antibody molecule,e.g., Ab 67-11, FI6, FI28, C179, F10, CR9114, or CR6261, e.g., whentested by the method described in (i).

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from SEQ ID NO: 24, e.g., the antibodymolecule comprises one or more or all of FR1, FR2, FR3, or FR4, orsequences that differ individually, or collectively, by no more than 1,2, 3, 4, of 5 amino acid residues, e.g., conservative residues, from SEQID NO: 24; and b) one or more framework regions (FRs) from SEQ ID NO:45, e.g., the antibody molecule comprises one or more or all of FR1,FR2, FR3, or FR4, or sequences that differ individually, orcollectively, by no more than 1, 2, 3, 4, of 5 amino acid residues,e.g., conservative residues, from SEQ ID NO: 45.

In one embodiment, the antibody molecule comprises: (a) a heavy chainimmunoglobulin variable region segment that further comprises one ormore or all of: an FR1 comprising the sequenceE-V-Q-L-L-E-S-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ IDNO:82) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom,optionally provided that T is not changed); an FR2 comprising thesequence W-V-R-Q-P-P-G-K-G-L-E-W-V-A (SEQ ID NO:75) (or a sequence thatdiffers by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids,e.g., conservative amino acids, therefrom, optionally provided that W isnot changed, or that if changed, is other than R); an FR3 comprising thesequence R-F-T-I-S-R-D-N-S-K-N-T-L-Y-L-Q-M-N-S-L-R-A-E-D-T-A-V-Y-Y-C-A-K(SEQ ID NO:76) (or a sequence that differs by no more than, 1, 2, 3, 4,or 5, e.g., 1 or 2 amino acids, e.g., conservative amino acids,therefrom, optionally provided that one, two or three of I, R, or L isnot changed, or that if I is changed it is other than G, if R is changedit is other than P. or if L is changed it is other than A); and an FR4comprising the sequence W-G-Q-G-T-T-L-T-V-S-S (SEQ ID NO:77) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom) orW-G-Q-G-T-T-V-T-V-S-S (SEQ ID NO:171) (or a sequence that differs by nomore than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom); and (a) a light chainimmunoglobulin variable region segment further comprises one or more orall of: an FR1 comprising the sequenceD-I-Q-M-T-Q-S-P-S-S-L-S-A-S-V-G-D-R-V-T-I-T-C-R-S-S (SEQ ID NO:78) (or asequence that differs by no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2amino acids, e.g., conservative amino acids, therefrom, optionallyprovided that R is not changed); an FR2 comprising the sequenceW-Y-Q-Q-K-P-G-K-A-P-K-L-L-I-Y (SEQ ID NO:79) (or a sequence that differsby no more than, 1, 2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g.,conservative amino acids, therefrom); an FR3 comprising the sequenceG-V-P-S-R-F-S-G-S-G-S-G-T-D-F-T-L-T-I-S-S-L-Q-P-E-D-F-A-T-Y-Y-C (SEQ IDNO:80) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom,optionally provided that C is not changed, or if changed, is other thanP); and an FR4 comprising the sequence F-G-Q-G-T-K-V-E-I-K (SEQ IDNO:81) (or a sequence that differs by no more than, 1, 2, 3, 4, or 5,e.g., 1 or 2 amino acids, e.g., conservative amino acids, therefrom). Inan embodiment a FR of the light or heavy chain includes one of thehighlighted residues, or one of the highlighted combinations ofresidues, for that FR, (i.e., while other residues in that FR might bechanged, the highlighted residue or combination of residues, are notchanged). E.g., in an embodiment, one, two or three of I, R, or L forheavy chain FR3 is not changed. In an embodiment a FR of the light and aFR of the heavy chain each includes one of the highlighted residues, orone of the highlighted combinations of residues, for that FR.

In an embodiment each of two FRs in the antibody molecule includes oneof the highlighted residues, or one of the highlighted combinations ofresidues, for that FR. In some embodiments, both are in the light chain.In some embodiments, both are in the heavy chain. In an embodiment, eachof FR2 and FR3 in the heavy chain includes one of the highlightedresidues, or one of the highlighted combinations of residues, for thatFR. In an embodiment, each of FR1 and FR2 in the heavy and light chainincludes one of the highlighted residues for that FR. In an embodiment,all of the highlighted residues in heavy chain FR1-4 are unchanged. Inan embodiment, all of the highlighted residues in light chain FR1-4 areunchanged. In an embodiment, all of the highlighted residues in bothheavy and light chain FR1-4 are unchanged.

In one embodiment, the antibody molecule comprises: (a) the heavy chainimmunoglobulin variable region segment comprises one or more or all ofan FR1 comprising the sequenceE-V-Q-L-L-E-S-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ IDNO:82); an FR2 comprising the sequence W-V-R-Q-P-P-G-K-G-L-E-W-V-A (SEQID NO:75); an FR3 comprising the sequenceR-F-T-I-S-R-D-N-S-K-N-T-L-Y-L-Q-M-N-S-L-R-A-E-D-T-A-V-Y-Y-C-A-K (SEQ IDNO:76); and an FR4 comprising the sequence W-G-Q-G-T-T-L-T-V-S-S (SEQ IDNO:77) or W-G-Q-G-T-T-V-T-V—S-S (SEQ ID NO:171); and (b) the light chainimmunoglobulin variable region segment comprising one or more or all ofan FR1 comprising the sequenceD-I-Q-M-T-Q-S-P-S-S-L-S-A-S-V-G-D-R-V-T-I-T-C-R-S-S (SEQ ID NO:78); anFR2 comprising the sequence W-Y-Q-Q-K-P-G-K-A-P-K-L-L-I-Y (SEQ IDNO:79); an FR3 comprising the sequenceG-V-P-S-R-F-S-G-S-G-S-G-T-D-F-T-L-T-I-S-S-L-Q-P-E-D-F-A-T-Y-Y-C(SEQ IDNO:80); and an FR4 comprising the sequence F-G-Q-G-T-K-V-E-I-K (SEQ IDNO:81).

In another embodiment, the antibody molecule comprises one or more orall of the following properties: (a) it fails to produce any escapemutants as determined by the failure of a viral titer to recoverfollowing at least 10, 9, 8, 7, 6, or 5 rounds of serial infections incell culture with a mixture of the antibody molecule and an influenzavirus (e.g., an influenza A virus, e.g., a Group 1 strain, e.g., an H1N1strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004, or an influenza B virus, e.g., B/Wisconsin/1/2010);(b) it produces fewer escape mutants than does a reference anti-HAantibody molecule, e.g., Ab 67-11, FI6, FI28, C179, F10, CR9114, orCR6261, e.g., when tested by the method described in (a); (c) it bindswith high affinity to a hemagglutinin (HA) of at least 1, 2, 3, 4 or 5influenza subtypes of Group 1 and at least 1, 2, 3, 4 or 5 influenzasubtypes of Group 2; (d) it treats or prevents infection by at least 1,2, 3, 4 or 5 influenza subtypes of Group 1, and by at least 1, 2, 3, 4or 5 influenza subtypes of Group 2; (e) it inhibits fusogenic activityof the targeted HA; (f) it treats or prevents infection by a Group 1virus, wherein the virus is an H1, H5, or H9 virus; and treats orprevents infection by a Group 2 virus, wherein the virus is an H3 or H7virus; (g) it treats or prevents infection by influenza A strains H1N1and H3N2; (h) it is effective for prevention or treatment of infection,e.g., in humans or mice, with H1N1 and H3N2 when administered at 50mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg,or 1 mg/kg; (i) it treats or prevents infection by influenza A strainsH5N1; (j) it is effective for prevention or treatment of infection,e.g., in humans or mice, with H5N1 when administered at 50 mg/kg, 25mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1mg/kg; (k) it binds with high affinity to a hemagglutinin (HA) of aninfluenza B virus, e.g., B/Wisconsin/1/2010; (l) it treats or preventsinfection by an influenza B virus, e.g., B/Wisconsin/1/2010; (m) it iseffective for prevention or treatment of infection, e.g., in humans ormice, with an influenza B virus, e.g., B/Wisconsin/1/2010 whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg, or 1 mg/kg; (n) the concentration of antibody moleculerequired for 50% neutralization of influenza A virus is less than 10μg/mL; (o) the concentration of antibody molecule required for 50%neutralization of influenza B virus, e.g., B/Wisconsin/1/2010, is lessthan 10 μg/mL; (p) it prevents or minimizes secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject; (q) itis effective for preventing or minimizing secondary infection (e.g.,secondary bacterial infection) or effects thereof on a subject whenadministered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg,3 mg/kg, 2 mg/kg, or 1 mg/kg; (r) it binds an epitope which comprises orconsists of the hemagglutinin trimer interface; and (s) it binds anepitope other than that bound by a reference anti-HA antibody molecule,e.g., Ab 67-11, FI6, FI28, C179, F10, CR9114, or CR6261, e.g., whentested by a method disclosed herein, e.g., by competition in an ELISAassay.

In another aspect, the disclosure features an antibody moleculecomprising: (a) a heavy chain immunoglobulin variable region segmentcomprising SEQ ID NO:24 (or a sequence that differs by no more than 1,2, 3, 4 or 5 amino acids, e.g., conservative amino acids, therefrom);and (b) a light chain variable region segment comprising SEQ ID NO:45(or a sequence that differs by no more than 1, 2, 3, 4 or 5 amino acids,e.g., conservative amino acids, therefrom). In some embodiments, theantibody molecule comprises one or more or all of the followingproperties: (i) it fails to produce any escape mutants as determined bythe failure of a viral titer to recover following at least 10, 9, 8, 7,6, or 5 rounds of serial infections in cell culture with a mixture ofthe antibody molecule and an influenza a virus, e.g., a Group 1 strain,e.g., an H1N1 strain, e.g., A/South Carolina/1/1918, A/PuertoRico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004; and (ii) it produces fewerescape mutants than does a reference anti-HA antibody molecule, such asAb 67-11, F16, FI28, C179, F10, CR9114, or CR6261, such as when testedby the method described in (i).

In an embodiment, the binding agent, e.g., an antibody molecule,specifically binds the HA antigen. In an embodiment, the antibodymolecule binds an epitope that has one, two, three, four, five, or allof, the following properties a)-f): a) it includes one, two, or all of,H3 HA1 residues N38, 1278, and D291; b) it includes H3 HA2 residue N12;c) it does not include one, two or all of, H3 HA1 residues Q327, T328,and R329; d) it does not include one, two, three, four, or all of, H3HA2 residues G1, L2, F3, G4, and D46; e) it includes one, two, or allof, H3 HA1 residues T318, R321, and V323; or f) it includes 1, 2, 3, 4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H3 HA2residues A7, E11, I18, D19, G20, W21, L38, K39, T41, Q42, A43, I45, I48,N49, L52, N53, I56, and E57. In an embodiment, the antibody molecule hasproperties: a) and b). antibody molecule has properties: c) and d). Inan embodiment, the antibody molecule has properties: a); and c) or d).In an embodiment, the antibody molecule has properties: b); and c) ord). In an embodiment, the antibody molecule has properties: c); and a)or b). In an embodiment, the antibody molecule has properties: d); anda) or b).

In an embodiment, the antibody molecule has properties: a), b), c) andd). In an embodiment, the antibody molecule has properties: a), b), c),d), e), and f). In an embodiment, the antibody molecule has a K_(D) forH3 of equal to or less than 10⁻⁶, wherein said K_(D) is increased by atleast 2, 5, 10, or 100 fold, by a mutation or mutations in any of: a) H3HA1 residues N38, 1278, or D291; b) H3 HA2 residue N12; c) H3 HA1residues T318, R321, or V323; or d) H3 HA2 residues A7, E11, I18, D19,G20, W21, L38, K39, T41, Q42, A43, I45, I48, N49, L52, N53, 156, or E57.In an embodiment, the antibody molecule has a K_(D) for H3 of equal toor less than 10⁻⁶, wherein said K_(D) is increased by no more than 2, or5 fold, by a mutation or mutations in any of: c) H3 HA1 residues Q327,T328, or R329; or d) H3 HA2 residues G1, L2, F3, G4, or D46.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties aa)-ff): aa)it includes one, two, or all of, H1 HA1 residues H31, N279, and S292;bb) it includes H1 HA2 residue G12; cc) it does not include one or bothof H1 HA1 residues Q328 and S329; dd) it does not include one, two,three, four, or all of, H1 HA2 residues G1, L2, F3, G4, and D46; ee) itincludes one, two, or all of, H1 HA1 residues T319, R322, and 1324 arebound by both Ab 044 and F16; or ff) it includes 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H1 HA2 residues A7, E11,I18, D19, G20, W21, Q38, K39, T41, Q42, N43, I45, I48, T49, V52, N53,156, and E57. In an embodiment, the antibody molecule has properties:aa) and bb). In an embodiment, the antibody molecule has properties: cc;and dd. In an embodiment, the antibody molecule has properties: aa); andcc) or dd). In an embodiment, the antibody molecule has properties: bb);and cc) or dd). In an embodiment, the antibody molecule has properties:cc); and aa) or bb). In an embodiment, the antibody molecule hasproperties: dd); and aa) or bb). In an embodiment, the antibody moleculehas properties: aa), bb), cc) and dd). In an embodiment, the antibodymolecule has properties: aa), bb), cc), dd), ee), and ff). In anembodiment, the antibody molecule has a K_(D) for H1 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10, or 100fold, by a mutation or mutations in any of: aa) H1 HA1 residues H31,N279, and S292; bb) H1 HA2 residue G12; cc) H1 HA1 residues T319, R322,and 1324; or dd) H1 HA2 residues A7, E11, I18, D19, G20, W21, Q38, K39,T41, Q42, N43, I45, I48, T49, V52, N53, 156, and E57. In an embodiment,the antibody molecule has a K_(D) for H1 of equal to or less than 10⁻⁶,wherein said K_(D) is increased by no more than 2, or 5 fold, by amutation or mutations in any of: cc) H1 HA1 residues Q328 and S329; ordd) H1 HA2 residues G1, L2, F3, G4, and D46; In an embodiment, theantibody molecule has one, two, three or all of the followingproperties: a) and aa); b) and bb); c) and cc); d) and dd). In anembodiment, the molecule has properties c), cc), d), and dd).

In another aspect, the disclosure features, a binding agent, e.g., anantibody molecule, or preparation, or isolated preparation thereof,comprising a structural or functional property of one or both a heavychain variable region and a light chain variable region disclosedherein.

In an embodiment, the antibody molecule competes with a referenceantibody molecule, e.g., an antibody molecule described herein, forbinding to a substrate, e.g., an HA. The reference antibody molecule canbe: a) an antibody molecule comprising the heavy and light CDRs from: aheavy chain variable region from Table 3, Table 4A, or Table 4B, or FIG.2, FIG. 13, or FIG. 17, of International Publication No. WO2013/170139or U.S. Application Publication No. 2013/0302349; and a light chainvariable region from Table 3, Table 4A, or Table 4B, or FIG. 3, FIG. 14,or FIG. 17, of International Publication No. WO2013/170139 or U.S.Application Publication No. 2013/0302349; b) an antibody molecule thatcomprises: (i) a heavy chain immunoglobulin variable region segment fromTable 3, Table 4A, or Table 4B, or FIG. 2, FIG. 13, or FIG. 17, ofInternational Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; and (ii) a light chain variable regionsegment from Table 3, Table 4A, or Table 4B, or FIG. 3, FIG. 14, or FIG.17, of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; or c) an antibody disclosed herein.

The HA can be HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004.Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, e.g. from anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;and c) flow cytometry. The antibody molecule can compete with thereference antibody such that binding of the reference antibody isdecreased by 50% or more. In an embodiment, the antibody molecule bindsto the same epitope, or a portion thereof, which the reference antibodymolecule binds. In an embodiment, the antibody molecule does not bind tothe same epitope, or a portion thereof, which the reference antibodymolecule binds.

In an embodiment, the antibody molecule binds to the same epitope, or aportion thereof, on HA, as does a reference antibody molecule, e.g. anantibody molecule disclosed herein. The reference antibody molecule canbe: a) an antibody molecule comprising the heavy and light CDRs from: aheavy chain variable region from Table 3, Table 4A, or Table 4B, or FIG.2, FIG. 13, or FIG. 17, of International Publication No. WO2013/170139or U.S. Application Publication No. 2013/0302349; and a light chainvariable region from Table 3, Table 4A, or Table 4B, or FIG. 3, FIG. 14,or FIG. 17, of International Publication No. WO2013/170139 or U.S.Application Publication No. 2013/0302349; b) an antibody molecule thatcomprises: (i) a heavy chain immunoglobulin variable region segment fromTable 3, Table 4A, or Table 4B, FIG. 2, FIG. 13, or FIG. 17, ofInternational Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; and (ii) a light chain variable regionsegment from Table 3, Table 4A, or Table 4B, FIG. 3, FIG. 14, or FIG.17, of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; or c) an antibody disclosed herein.

The HA can be HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004. Binding tothe same epitope, or a portion thereof, can be shown by one or more of:a) mutational analysis, e.g., binding to HA, or binding affinity for HA,is decreased or abolished if a residue is mutated; b) analysis, e.g.,comparison, of the crystal structure of the antibody molecule and HA andthe crystal structure of a reference antibody and HA, e.g., to determinethe touch points of each; c) competition of the two antibodies forbinding to HA, e.g., HA1 or HA5, e.g. from an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004; and d) (c)and one or both of (a) and (b).

Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, from, e.g., anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art. Reduction of the ability to bind can beevaluated, e.g., by one or more of: a) Biacore analysis; b) ELISA assay;and c) flow cytometry. The antibody molecule can compete with thereference antibody such that binding of the reference antibody isdecreased by 50% or more; d) competition of the two antibodies forbinding to HA, e.g., HA1 or HA5, from, e.g., an H1N1 strain, e.g.,A/South Carolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004; ande) (c) and one or both of (a) and (b).

Competition between the antibody molecule and a reference antibodymolecule can be determined by evaluating the ability of one of theantibody molecule or the reference antibody molecule to decrease bindingof the other to a substrate, e.g., HA, e.g., HA1 or HA5, from, e.g., anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004. Reduction of the ability to bind can be evaluatedby methods in the art.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region comprising least60, 70, 80, 85, 90, 95, 98 or 99 percent homology with a reference heavychain from Table 3, Table 4A, or Table 4B, or FIG. 2, FIG. 13 or FIG.17, of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; and a light chain variable regioncomprising least 60, 70, 80, 85, 90, 95, 98 or 99 percent homology withreference light chain from Table 3, Table 4A, or Table 4B, or FIG. 3,FIG. 14 or FIG. 17, of International Publication No. WO2013/170139 orU.S. Application Publication No. 2013/0302349, wherein, optionally, eachHC CDR differs by no more than 1, 2, 3, 4 or 5 amino acids, e.g., 1 or2, e.g., conservative amino acids, from the corresponding HC CDR fromits reference heavy chain and each LC CDR differs by no more than 1, 2,3, 4 or 5 amino acids, e.g., 1 or 2, e.g., conservative amino acids,from the corresponding CDR in its reference light chain. In anembodiment, the binding agent, e.g., an antibody molecule, comprises: aheavy chain variable region comprising least 60, 70, 80, 85, 90, 95, 98or 99 percent homology with a heavy chain from Table 3 and a light chainvariable region comprising least 60, 70, 80, 85, 90, 95, 98 or 99percent homology with the corresponding light chain from Table 3. In anembodiment, the binding agent, e.g., an antibody molecule, comprises: aheavy chain variable region comprising least 60, 70, 80, 85, 90, 95, 98or 99 percent homology with a heavy chain from Table 4A and a lightchain variable region comprising least 60, 70, 80, 85, 90, 95, 98 or 99percent homology with the corresponding light chain from Table 4A. In anembodiment, the binding agent, e.g., an antibody molecule, comprises: aheavy chain variable region comprising least 60, 70, 80, 85, 90, 95, 98or 99 percent homology with a heavy chain from Table 4B and a lightchain variable region comprising least 60, 70, 80, 85, 90, 95, 98 or 99percent homology with the corresponding light chain from Table 4B.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: a heavy chain variable region from Table 3,Table 4A, or Table 4B, or FIG. 2, FIG. 13, or FIG. 17, of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349; and a light chain variable region from Table 3, Table 4A,or Table 4B, or FIG. 3, FIG. 14, or FIG. 17, of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349. In an embodiment, the binding agent, e.g., an antibodymolecule, comprises: a heavy chain variable region from Table 3 and thecorresponding light chain from Table 3; a heavy chain from Table 4A andthe corresponding light chain from Table 4A; or a heavy chain from Table4B and the corresponding light chain from Table 4B.

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: (a) a heavy chain immunoglobulin variableregion segment comprising a CDR1, a CDR2 and a CDR3 from a heavy chainsequence of Table 3, Table 4A, or Table 4B, or FIG. 2, FIG. 13, or FIG.17, of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349 (or CDRs that, individually orcollectively, differ therefrom by no more than, 1, 2, 3, 4, or 5, e.g.,1 or 2 amino acids, e.g., conservative amino acids)); and (b) a lightchain immunoglobulin variable region segment comprising a CDR1, a CDR2and a CDR3 from a light chain sequence of Table 3, Table 4A, or Table4B, or FIG. 3, FIG. 14, or FIG. 17, of International Publication No.WO2013/170139 or U.S. Application Publication No. 2013/0302349 (or CDRsthat, individually or collectively, differ therefrom by no more than, 1,2, 3, 4, or 5, e.g., 1 or 2 amino acids, e.g., conservative aminoacids).

In an embodiment, the binding agent, e.g., an antibody molecule,comprises one or both of: CDRs from a heavy chain of Table 3 and thelight chain CDRs from the corresponding light chain from Table 3. In anembodiment, the binding agent, e.g., an antibody molecule, comprises oneor both of: CDRs from a heavy chain of Table 4A and the light chain CDRsfrom the corresponding light chain from Table 4A. In an embodiment, thebinding agent, e.g., an antibody molecule, comprises one or both of:CDRs from a heavy chain of Table 4B and the light chain CDRs from thecorresponding light chain from Table 4B.

In some embodiments, the binding agent, e.g., an antibody molecule,comprises one or more or all of the following properties: (i) it failsto produce any escape mutants as determined by the failure of a viraltiter to recover following at least 10, 9, 8, 7, 6, or 5 rounds ofserial infections in cell culture with a mixture of the antibodymolecule and an influenza virus (e.g., an influenza A virus, e.g., aGroup 1 strain, e.g., an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004, or an influenza B virus,e.g., B/Wisconsin/1/2010); (ii) it produces fewer escape mutants thandoes a reference anti-HA antibody molecule, e.g., Ab 67-11, FI6, FI28,C179, F10, CR9114, or CR6261, e.g., when tested by the method describedin (i); and (iii) it is other than Ab 67-11 and FI6.

In one embodiment, the antibody molecule comprises one or both of: (a) aheavy chain immunoglobulin variable region segment comprising a CDR1, aCDR2; and a CDR3 from a heavy chain sequence of FIG. 2, FIG. 13, or FIG.17, of International Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349; and (b) a light chain immunoglobulinvariable region segment comprising a CDR1, a CDR2 and a CDR3 from alight chain sequence of FIG. 3, FIG. 14, or FIG. 17, of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349. In one embodiment, the antibody molecule comprises: (a) aheavy chain immunoglobulin variable region segment from FIG. 2 or FIG.17; and (b) a light chain immunoglobulin variable region segment fromFIG. 3 or FIG. 17.

In one embodiment, the heavy chain immunoglobulin variable regionfurther comprises an Isoleucine-Aspartate (Ile-Asp) dipeptide at theN-terminus. In another embodiment, the light chain immunoglobulinvariable region further comprises an Ile-Asp dipeptide at theN-terminus. In yet another embodiment, both the heavy chainimmunoglobulin variable region and the light chain immunoglobulinvariable region or an antibody featured in the disclosure furthercomprises an Ile-Asp dipeptide at the N-terminus. In other embodimentthe Ile-Asp dipeptide is absent from one or both the heavy and lightchain.

In one embodiment, the binding agent, e.g., an antibody molecule,further comprises one or more or all of the following: (a) it treats orprevents infection by at least 1, 2, 3, 4 or 5 influenza subtypes ofGroup 1, and by at least 1, 2, 3, 4 or 5 influenza subtypes of Group 2;(b) it inhibits fusogenic activity of the targeted HA; (c) it treats orprevents infection by a Group 1 virus, wherein the virus is an H1, H5,or H9 virus; and treats or prevents infection by a Group 2 virus,wherein the virus is an H3 or H7 virus; (d) it treats or preventsinfection by influenza A strains H1N1 and H3N2; (e) it is effective forprevention or treatment of infection, e.g., in humans or mice, with H1N1and H3N2 when administered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg; (f) it treats or preventsinfection by influenza A strains H5N1; (g) it is effective forprevention or treatment of infection, e.g., in humans or mice, with H5N1when administered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6 mg/kg, 5 mg/kg, 4mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg; (h) it binds with high affinity toa hemagglutinin (HA) of an influenza B virus, e.g., B/Wisconsin/1/2010;(i) it treats or prevents infection by an influenza B virus, e.g.,B/Wisconsin/1/2010; (j) it is effective for prevention or treatment ofinfection, e.g., in humans or mice, with an influenza B virus, e.g.,B/Wisconsin/1/2010 when administered at 50 mg/kg, 25 mg/kg, 10 mg/kg, 6mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg; (k) theconcentration of antibody molecule required for 50% neutralization ofinfluenza A virus is less than 10 μg/mL; (l) the concentration ofantibody molecule required for 50% neutralization of influenza B virus,e.g., B/Wisconsin/1/2010, is less than 10 μg/mL; (m) it prevents orminimizes secondary infection (e.g., secondary bacterial infection) oreffects thereof on a subject; (n) it is effective for preventing orminimizing secondary infection (e.g., secondary bacterial infection) oreffects thereof on a subject when administered at 50 mg/kg, 25 mg/kg, 10mg/kg, 6 mg/kg, 5 mg/kg, 4 mg/kg, 3 mg/kg, 2 mg/kg, or 1 mg/kg; (o) itbinds an epitope which comprises or consists of the hemagglutinin trimerinterface; and (p) it binds an epitope other than that bound by areference anti-HA antibody molecule, e.g., Ab 67-11, F16, F128, C179,F10, CR9114, or CR6261, e.g., when tested by a method disclosed herein,e.g., by competition in an ELISA assay.

In an embodiment, the antibody molecule comprises one or both of: a) oneor more framework regions (FRs) from heavy chain disclosed herein, e.g.,the antibody molecule comprises one or more or all of FR1, FR2, FR3, orFR4, or sequences that differ individually, or collectively, by no morethan 1, 2, 3, 4, of 5 amino acid residues, e.g., conservative residues,from heavy chain disclosed herein; and b) one or more framework regions(FRs) from light chain disclosed herein, e.g., the antibody moleculecomprises one or more or all of FR1, FR2, FR3, or FR4, or sequences thatdiffer individually, or collectively, by no more than 1, 2, 3, 4, of 5amino acid residues, e.g., conservative residues, from light chaindisclosed herein.

In an embodiment, the binding agent, e.g., an antibody molecule,specifically binds the HA antigen. In an embodiment, the antibodymolecule binds an epitope that has one, two, three, four, five, or allof, the following properties a)-f): a) it includes one, two, or all of,H3 HA1 residues N38, 1278, and D291; b) it includes H3 HA2 residue N12;c) it does not include one, two or all of, H3 HA1 residues Q327, T328,and R329; d) it does not include one, two, three, four, or all of, H3HA2 residues G1, L2, F3, G4, and D46; e) it includes one, two, or allof, H3 HA1 residues T318, R321, and V323; or f) it includes 1, 2, 3, 4,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H3 HA2residues A7, E11, I18, D19, G20, W21, L38, K39, T41, Q42, A43, I45, I48,N49, L52, N53, I56, and E57. In an embodiment, the antibody molecule hasproperties: a) and b). In an embodiment, the antibody molecule hasproperties: c) and d). In an embodiment, the antibody molecule hasproperties: a); and c) or d). In an embodiment, the antibody moleculehas properties: b); and c) or d). In an embodiment, the antibodymolecule has properties: c); and a) or b). In an embodiment, theantibody molecule has properties: d); and a) or b). In an embodiment,the antibody molecule has properties: a), b), c) and d). In anembodiment, the antibody molecule has properties: a), b), c), d), e),and f). In an embodiment, the antibody molecule has a K_(D) for H3 ofequal to or less than 10⁻⁶, wherein said K_(D) is increased by at least2, 5, 10, or 100 fold, by a mutation or mutations in any of: a) H3 HA1residues N38, 1278, or D291; b) H3 HA2 residue N12; c) H3 HA1 residuesT318, R321, or V323; or d) H3 HA2 residues A7, E11, I18, D19, G20, W21,L38, K39, T41, Q42, A43, I45, I48, N49, L52, N53, 156, or E57. In anembodiment, the antibody molecule has a K_(D) for H3 of equal to or lessthan 10⁻⁶, wherein said K_(D) is increased by no more than 2, or 5 fold,by a mutation or mutations in any of: c) H3 HA1 residues Q327, T328, orR329; or d) H3 HA2 residues G1, L2, F3, G4, or D46.

In an embodiment, the antibody molecule binds an epitope that has one,two, three, four, five, or all of, the following properties aa)-ff): aa)it includes one, two, or all of, H1 HA1 residues H31, N279, and S292;bb) it includes H1 HA2 residue G12; cc) it does not include one or bothof H1 HA1 residues Q328 and S329; dd) it does not include one, two,three, four, or all of, H1 HA2 residues G1, L2, F3, G4, and D46; ee) itincludes one, two, or all of, H1 HA1 residues T319, R322, and 1324 arebound by both Ab 044 and F16; or ff) it includes 1, 2, 3, 4, 5, 6, 7, 8,9, 10, 11, 12, 13, 14, 15, 16, 17, or all of, H1 HA2 residues A7, E11,I18, D19, G20, W21, Q38, K39, T41, Q42, N43, I45, I48, T49, V52, N53,156, and E57. In an embodiment, the antibody molecule has properties:aa) and bb). In an embodiment, the antibody molecule has properties: cc)and dd). In an embodiment, the antibody molecule has properties: aa);and cc) or dd). In an embodiment, the antibody molecule has properties:bb); and cc) or dd). In an embodiment, the antibody molecule hasproperties: cc); and aa) or bb). In an embodiment, the antibody moleculehas properties: dd); and aa) or bb). In an embodiment, the antibodymolecule has properties: aa), bb), cc) and dd). In an embodiment, theantibody molecule has properties: aa), bb), cc), dd), ee), and ff). Inan embodiment, the antibody molecule has a K_(D) for H1 of equal to orless than 10⁻⁶, wherein said K_(D) is increased by at least 2, 5, 10, or100 fold, by a mutation or mutations in any of: aa) H1 HA1 residues H31,N279, and S292; bb) H1 HA2 residue G12; cc) H1 HA1 residues T319, R322,and 1324; or dd) H1 HA2 residues A7, E11, I18, D19, G20, W21, Q38, K39,T41, Q42, N43, I45, I48, T49, V52, N53, 156, and E57. In an embodiment,the antibody molecule has a K_(D) for H1 of equal to or less than 10⁻⁶,wherein said K_(D) is increased by no more than 2, or 5 fold, by amutation or mutations in any of: cc) H1 HA1 residues Q328 and S329; ordd) H1 HA2 residues G1, L2, F3, G4, and D46; In an embodiment, theantibody molecule has one, two, three or all of the followingproperties: a) and aa); b) and bb); c) and cc); d) and dd). In anembodiment, the molecule has properties c), cc), d), and dd).

In one aspect, the disclosure features an anti-hemagglutinin (anti-HA)binding agent, e.g., antibody molecule, or preparation, or isolatedpreparation thereof, comprising: (a) a heavy chain immunoglobulinvariable region segment comprising one or more or all of a CDR1comprising the sequence G-F-T-F-[S/T]-[S/T]-Y-[A/G]-M-H (SEQ ID NO: 1),or a sequence that differs from SEQ ID NO:1 by no more than 1 or 2residues; a CDR2 comprising the sequenceV-[I/V/L]-S-[Y/F]-D-G-[S/N]-[Y/N]-[K/R]-Y-Y-A-D-S-V-Q-G (SEQ ID NO:2) ora sequence that differs from SEQ ID NO:2 by no more than 1 or 2residues; and a CDR3 comprising the sequenceD-[S/T]-[R/K/Q]-L-R-[S/T]-L-L-Y-F-E-W-L-S-[Q/S]-G-[Y/L/V]-[F/L]-[N/D]-[P/Y](SEQ ID NO:3), or a sequence that differs from SEQ ID NO:3 by no morethan 1 or 2 residues; and (b) a light chain variable region segmentcomprising one or more or all of a CDR1 comprising the sequence[K/R]-S-S-Q-[S/T]-[V/L/I]-[T/S]-[Y/F/W]-[N/S/D]-Y-K-N-Y-L-A (SEQ IDNO:4) or a sequence that differs from SEQ ID NO:4 by no more than 1 or 2residues, or comprising the sequence[K/R]-S-S-Q-[S/T]-[V/L/I]-[T/S]-[Y/F/W]-[N/S/D/Q/R/E]-Y-K-N-Y-L-A (SEQID NO: 170) or a sequence that differs from SEQ ID NO: 170 by no morethan 1 or 2 residues or[K/R]-S-S-Q-[S/T]-[V/L/I]-[T/S]-[Y/F/W]-[N/S/D/E]-Y-K-N-Y-L-A (SEQ IDNO:4) or a sequence that differs from SEQ ID NO: 170 by no more than 1or 2 residues; a CDR2 comprising the sequenceW-[A/G]-S-[T/A/Y/H/K/D]-[R/L]-E-[S/T] (SEQ ID NO:5) or a sequence thatdiffers from SEQ ID NO:5 by no more than 1 or 2 residues; a CDR3comprising the sequence Q-Q-[Y/H]-Y-R-T-P-P-[T/S] (SEQ ID NO:6) or asequence that differs from SEQ ID NO:6 by no more than 1 or 2 residues;

optionally, provided that, if the light chain variable region segmentcomprises: a CDR 1 comprising the sequence K-S-S-Q-S-V-T-Y-N-Y-K-N-Y-L-A(SEQ ID NO:83); a CDR2 comprising the sequence W-A-S-T-R-E-S (SEQ IDNO:84); and a CDR3 comprising the sequence Q-Q-Y-Y-R-T-P-P-T (SEQ IDNO:85); then the heavy chain variable region segment comprises one ormore of the following: (a) CDRs other than the following: a CDR1comprising the sequence S-Y-G-M-H (SEQ ID NO:86); a CDR2 comprising thesequence V-I-S-Y-D-G-S-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:87); or a CDR3comprising the sequence D-S-E-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ IDNO:88); or (b) FRs other than the following: an FR1 other thanE-V-Q-L-L-E-S-G-G-G-L-V-K-P-G-Q-S-L-K-L-S-C-A-A-S-G-F-T-F-T (SEQ IDNO:82); an FR2 other than W-V-R-Q-P-P-G-K-G-L-E-W-V-A (SEQ ID NO:75); anFR3 other thanR-F-T-I-S-R-D-N-S-K-N-T-L-Y-L-Q-M-N-S-L-R-A-E-D-T-A-V-Y-Y-C-A-K (SEQ IDNO:76); or an FR4 other than W-G-A-G-T-T-L-T-V-S-S (SEQ ID NO:89); (c) aCDR1 where the amino residue at position 5 of SEQ ID NO: 1 is an S, theamino acid residue at position 6 of SEQ ID NO: 1 is a T, or the aminoacid residue at position 8 of SEQ ID NO:1 is an A; (d) a CDR2 whereinthe amino residue at position 2 of SEQ ID NO:2 is a V or an L, the aminoacid at position 4 is an F, the amino acid at position 7 is an N, theamino acid at position 8 is a Y, or the amino acid at position 9 is a R;(e) a CDR3 wherein the amino residue at position 2 of SEQ ID NO:3 is aT, the amino acid residue at position 3 of SEQ ID NO:3 is an R, a K, ora Q, the amino acid residue at position 6 of SEQ ID NO:3 is a T, theamino acid residue at position 15 of SEQ ID NO:3 is an S, the amino acidresidue at position 17 of SEQ ID NO:3 is an L, or a V, the amino acidresidue at position 18 of SEQ ID NO:3 is an L, the amino acid residue atposition 19 of SEQ ID NO:3 is a D, or the amino acid residue at position20 of SEQ ID NO:3 is a Y; (f) an FR1 wherein the amino residue atposition 11 of SEQ ID NO:7 is a Q, or the amino acid residue at position7 of SEQ ID NO:7 is a T; (g) an FR4 wherein the amino residue atposition 3 of SEQ ID NO: 10 is a Q, the amino acid residue at position 5of SEQ ID NO: 10 is an A; the amino acid residue at position 6 of SEQ IDNO: 10 is an M, or the amino acid residue at position 7 of SEQ ID NO: 10is a V; or (h) it produces fewer escape mutants than does a referenceanti-HA antibody molecule, e.g., Ab 67-11, F16, F128, C179, F10, CR9114,or CR6261, e.g., when tested by a method disclosed herein, and alsoprovided that, if the heavy chain immunoglobulin variable region segmentcomprises: a CDR1 comprising the sequence S-Y-G-M-H (SEQ ID NO:86); aCDR2 comprising the sequence V-I-S-Y-D-G-S-Y-K-Y-Y-A-D-S-V-Q-G (SEQ IDNO:87); and a CDR3 comprising the sequenceD-S-E-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:88), then the lightchain variable region segment comprises one of more of the following:(a) CDRs other than the following: CDR1 KSSQSVTYNYKNYLA (SEQ ID NO:83);CDR2 WASTRES (SEQ ID NO:84); or CDR3 QQYYRTPPT (SEQ ID NO:85); (b) FRsother than the following: FR1 comprising the sequenceEIVMTQSPDSLAVSLGERATINC (SEQ ID NO:90); FR2 comprising the sequenceWYQQKPGQPPKLLIY (SEQ ID NO:91); FR3 comprising the sequenceGVPDRFSGSGSGTDFTLTISSLQAEDVAVYYC (SEQ ID NO:92); or FR4 comprising thesequence FGGGTKLDIK (SEQ ID NO:93); (c) a CDR1 wherein the amino residueat position 1 of SEQ ID NO:4 is an R, the amino residue at position 5 ofSEQ ID NO:4 is a T, the amino residue at position 6 of SEQ ID NO:4 is anL or an I, the amino residue at position 7 of SEQ ID NO:4 is an S, theamino residue at position 8 of SEQ ID NO:4 is an F or a W, or the aminoresidue at position 9 of SEQ ID NO:4 is an S or a D; (d) a CDR2 whereinthe amino residue at position 2 of SEQ ID NO:5 is a G, the amino residueat position 4 of SEQ ID NO:5 is an A, a Y, an H, a K, or a D, the aminoresidue at position 5 of SEQ ID NO:5 is an L, the amino residue atposition 7 of SEQ ID NO:5 is a T; (e) a CDR3 wherein the amino residueat position 3 of SEQ ID NO:6 is an H; the amino acid residue at position9 of SEQ ID NO:6 is an S; (f) an FR1 wherein the amino residue atposition 1 of SEQ ID NO:11 is a D; the amino residue at position 3 ofSEQ ID NO:11 is a Q, the amino residue at position 9 of SEQ ID NO:11 isan S, the amino residue at position 10 of SEQ ID NO:11 is a T, the aminoresidue at position 11 of SEQ ID NO:11 is a V, the amino residue atposition 12 of SEQ ID NO:11 is an S, the amino residue at position 13 ofSEQ ID NO:11 is an A, the amino residue at position 14 of SEQ ID NO:11is a T, the amino residue at position 15 of SEQ ID NO:11 is a V or an R,the amino residue at position 17 of SEQ ID NO:11 is a D, the aminoresidue at position 20 of SEQ ID NO:11 is an S, the amino residue atposition 22 of SEQ ID NO:11 is a T, a Q, a D, or an R; (g) an FR2wherein the amino residue at position 8 of SEQ ID NO: 12 is a K; or theamino residue at position 9 of SEQ ID NO: 12 is an A; (h) an FR3 whereinthe amino residue at position 4 of SEQ ID NO: 13 is an E or an S; theamino residue at position 24 of SEQ ID NO: 13 is a P, the amino residueat position 27 of SEQ ID NO: 13 is an F, a K, or a D, the amino residueat position 29 of SEQ ID NO: 13 is a T; (i) an FR4 wherein the aminoresidue at position 3 of SEQ ID NO: 14 is a Q, a T, an S, or an N, theamino residue at position 7 of SEQ ID NO: 14 is a V, or the aminoresidue at position 8 of SEQ ID NO: 14 is an E; or (j) it produces fewerescape mutants than does a reference anti-HA antibody molecule, e.g., Ab67-11, F16, F128, C179, F10, CR9114, or CR6261, e.g., when tested by amethod disclosed herein; and further provided that if the light chainvariable region segment comprises: a CDR 1 comprising the sequenceK-S-S-Q-S-V-T-F-N-Y-K-N-Y-L-A (SEQ ID NO: 146); a CDR2 comprising thesequence W-A-S-A-R-E-S (SEQ ID NO: 147); and a CDR3 comprising thesequence Q-Q-H-Y-R-T-P-P-T (SEQ ID NO: 148); then the heavy chainvariable region segment comprises one or more of the following: CDRsother than the CDR's described at FIG. 12 of International PublicationNo. WO2013/170139 or U.S. Application Publication No. 2013/0302349; orFRs other than the FRs described at FIG. 12 of International PublicationNo. WO2013/170139 or U.S. Application Publication No. 2013/0302349.

In one embodiment, the heavy chain CDR sequences, collectively, differfrom the recited sequences by no more than 5, 4, 3, 2 or 1 amino acidresidues; and the light chain CDR sequences, collectively, differ fromthe recited sequences by no more than 5, 4, 3, 2 or 1 amino acidresidues.

Unless otherwise defined, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. Although methods and materialssimilar or equivalent to those described herein can be used in thepractice or testing of the invention, suitable methods and materials aredescribed below. All publications, patent applications, patents, andother references mentioned herein are incorporated by reference in theirentirety. In case of conflict, the present specification, includingdefinitions, will control. In addition, the materials, methods, andexamples are illustrative only and not intended to be limiting.

The details of one or more embodiments featured in the disclosure areset forth in the accompanying drawings and the description below. Otherfeatures, objects, and advantages featured in the disclosure will beapparent from the description and drawings, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1B depict the pharmacokinetic profiles of VIS410 in serum (FIG.1A) and nasopharyngeal (FIG. 1B) samples. Mean concentrations along withthe corresponding standard deviation at each time point were plotted ona logarithmic scale for each dose level. Cohort dose levels are asfollows Cohort 1: 2 mg/kg; Cohort 2: 5 mg/kg; Cohort 3: 15 mg/kg; Cohort4: 30 mg/kg; Cohort 5: 50 mg/kg.

FIGS. 2A-2C depict the microsimulation results of VIS410 prophylacticuse. Changes in attack rate (FIG. 2A), overall hospitalization rate(FIG. 2B), and hospitalization rate in individuals older than 65 yearsof age (FIG. 2C) as a function of the population-level prophylaxiscoverage. The boxplots aggregate outcomes over time of administrationand transmission setting, as these epidemiological variables might insome cases be difficult to predict. The boxplots for 0% coveragesummarize 750 individual simulations, while the boxplots for 2% to 6%coverage summarize 3,750 simulations each. The yellow boxplots showresults for VIS410 administration to the elderly only, while the whiteboxplots show general population VIS410 administration. The whiskersshow the full range of outcomes, and the median value is shown next tothe median line of each boxplot. With one exception, all pairwisecomparisons between different coverage levels, when keeping the groupadministration method fixed (“all” or “elderly only”), show astatistically significant difference by the Mann-Whitney test (p=0-002);the one exception is in FIG. 2A when comparing no coverage to 2%coverage and distribution to the elderly only (significant at p=0-05).Note that in FIG. 2B when comparing elderly versus general populationdistribution, the Mann-Whitney p-values are p=0-21 (2% coverage), p=0-05(4% coverage), and p=0-005 (6% coverage).

FIG. 3 depicts the results of VIS410 prophylactic use stratified by dateof administration and transmission setting. Median baseline attack rate(MBAR) is used to separate the simulations into those that have low(<10%), medium (10%-16%), or high (>16%) median attack rates whencoverage is zero. In these simulations, VIS410 was administered to theelderly only and coverage was set to 6%. Each boxplot corresponds to 250simulations. The whiskers show the full range of outcomes, and themedian value is shown next to the median line of each boxplot. The grayline denotes the baseline median for each scenario when coverage iszero.

FIG. 4 depicts the protective levels conferred by VIS410 as a functionof time (half-life of 13 days).

FIG. 5 depicts the prevalence curves (375 simulations) of seasonalinfluenza for varying transmission scenarios. Filled colors show themiddle 90% ranges of simulation outputs classified into threetransmission intensities: attack rate >16% (red/severe), attack ratebetween 10% and 16% (blue/moderate), attack rate<10% (green/mild).

FIG. 6 depicts the cumulative prevalence curves (375 simulations) ofseasonal influenza for varying transmission scenarios. Filled colorsshow the middle 90% ranges of simulation outputs classified into threetransmission intensities: attack rate>16% (red/severe), attack ratebetween 10% and 16% (blue/moderate), attack rate<10% (green/mild).

FIG. 7 depicts the hospitalization curves (375 simulations) of seasonalinfluenza for varying transmission scenarios. Vertical axis shows totalnumber of hospitalized patients, of all ages, in a population of onemillion individuals. Filled colors show the middle 90% ranges ofsimulation outputs classified into three transmission intensities:attack rate>16% (red/severe), attack rate between 10% and 16%(blue/moderate), attack rate<10% (green/mild).

FIG. 8 depicts the sequence logo of predicted VIS410 epitope positionsfor H1N1 (top) and H3N2 (bottom) for influenza A strains collected from2012 through 2015.

FIG. 9 depicts the effect of VIS410 administration on elderlyhospitalization events for a low transmission (top panel) and hightransmission (bottom panel) epidemic. The effect of VIS410administration was modeled when prophylaxis was initiated 6 weeks(left), 4 weeks (center), and 2 weeks (right) prior to the peak of theepidemic.

FIG. 10A depicts the weight loss of animals infected with H1N1 PR8 anduntreated or treated with ribavirin or a prophylactic dose of VIS410(0.6, 2.5, or 10 mg/kg).

FIG. 10B depicts the Kaplan-Meier survival curves for animals infectedwith H1N1 PR8 and untreated or treated with ribavirin or a prophylacticdose of VIS410 (0.6, 2.5, or 10 mg/kg).

FIGS. 11A-11B depict the mean (+SD) serum (FIG. 11A) and nasopharyngeal(FIG. 11B) VIS410 concentration versus time profiles (log-linear scale).

FIG. 12A depicts the median viral shedding versus time profiles ofVIS410 compared to Placebo as measured by qRT-PCR in mITT population.

FIG. 12B depicts the median 50% tissue culture infective dose (TCID₅₀)time profiles of VIS410 compared to Placebo as measured by a cell basedassay in mITT population.

FIG. 13 depicts the time to resolution of upper respiratory tractsymptom score in mITT population.

FIG. 14A depicts the result of phenotypic resistance testing usingViroSpot™ assay.

FIG. 14B depicts the result of phenotypic resistance testing based onIC₅₀.

FIG. 15 depicts the in vivo ADE study design.

FIGS. 16A-16B depict the protection of CD-1 mice from influenza Avirus-induced morbidity by VIS410 in a dose dependent manner as comparedto irrelevant human IgG1.

FIG. 17 depicts the average lung viral load on Days 1 and 14 pi in CD-1mice treated with different doses of VIS410 and irrelevant human IgG1.

FIG. 18 depicts the tolerance of VIS410 to existing sequence variationin its epitope.

FIG. 19 depicts the evolutionary trajectory of VIS410 epitope.

Additional figures include FIGS. 1-27 of International Publication No.WO2013/170139 and U.S. Application Publication No. 2013/0302349, thecontents of which are incorporated by reference in their entirety.

DETAILED DESCRIPTION

The disclosure is based, at least in part, on the design and synthesisof antibody molecules that can bind an epitope that is conserved acrossmultiple hemagglutinin subtypes of influenza viruses (e.g., influenza Aand influenza B viruses). For example, the antibody molecules describedherein are useful as broad spectrum therapy against disease caused by atleast one influenza A strain belonging to Group 1 and one influenza Astrain belonging to Group 2 to neutralize infectivity of virusesbelonging to both Group 1 and Group 2 (at least one subtype of each).

The antibody molecules were designed by a rational structure-basedapproach to target a region on the virus that is not fully accessible tothe human immune system and, therefore, not amenable to antibodyselection through more classical screening approaches. Thisrational-based approach to the design and development of broad-spectrumantibody molecules allows for the development of more efficaciousvaccines for pandemic and seasonal influenza. This approach also allowsfor the advance preparation of pandemic vaccines so that they are readyto be employed against specific virus subtypes (e.g., avian virussubtypes) that may mutate to become human-adapted and highlytransmissible. Vaccines (e.g., seasonal vaccines) that utilize theantibody molecules described herein can generate a more potent immuneresponse without the use of adjuvants and provide broad protectionagainst viral strain variation.

The antibody molecules described herein can be used, e.g., in methods ofprotecting a population of subjects from influenza. For example, theprotection can include decreasing, in the population, the number ofhospital admissions, e.g. of influenza infected individuals; the numberincidents of influenza infection; the attack rate; or the number ofdeaths, e.g. of influenza infected individuals. In certain embodiments,the antibody molecules described herein can be used effectively andsafely as either a single-dose therapeutic or prophylactic forinfluenza. Without wishing to be bound by theory, it is believed that inan embodiment, including the antibody molecules described herein inprophylaxis among the public health interventions for influenza (e.g.,seasonal influenza) can result in beneficial effects, for example,lowering attack rates and reducing hospitalizations in high riskindividuals.

Definitions

As used herein, the term “antibody molecule” refers to a polypeptidethat comprises sufficient sequence from an immunoglobulin heavy chainvariable region and/or sufficient sequence from an immunoglobulin lightchain variable region, to provide antigen specific binding. It comprisesfull length antibodies as well as fragments thereof, e.g., Fabfragments, that support antigen binding. Typically an antibody moleculewill comprise heavy chain CDR1, CDR2, and CDR3 and light chain CDR1,CDR2, and CDR3 sequence. Antibody molecules include human, humanized,CDR-grafted antibodies and antigen binding fragments thereof. In someembodiments, an antibody molecule comprises a protein that comprises atleast one immunoglobulin variable region segment, e.g., an amino acidsequence that provides an immunoglobulin variable domain orimmunoglobulin variable domain sequence.

The VH or VL chain of the antibody molecule can further include all orpart of a heavy or light chain constant region, to thereby form a heavyor light immunoglobulin chain, respectively. In one embodiment, theantibody molecule is a tetramer of two heavy immunoglobulin chains andtwo light immunoglobulin chains.

An antibody molecule can comprise one or both of a heavy (or light)chain immunoglobulin variable region segment. As used herein, the term“heavy (or light) chain immunoglobulin variable region segment,” refersto an entire heavy (or light) chain immunoglobulin variable region, or afragment thereof, that is capable of binding antigen. The ability of aheavy or light chain segment to bind antigen is measured with thesegment paired with a light or heavy chain, respectively. In someembodiment, a heavy or light chain segment that is less than a fulllength variable region will, when paired with the appropriate chain,bind with an affinity that is at least 20, 30, 40, 50, 60, 70, 80, 90,or 95% of what is seen when the full length chain is paired with a lightchain or heavy chain, respectively.

An immunoglobulin variable region segment may differ from a reference orconsensus sequence. As used herein, to “differ,” means that a residue inthe reference sequence or consensus sequence is replaced with either adifferent residue or an absent or inserted residue.

An antibody molecule can comprise a heavy (H) chain variable region(abbreviated herein as VH), and a light (L) chain variable region(abbreviated herein as VL). In another example, an antibody comprisestwo heavy (H) chain variable regions and two light (L) chain variableregions or antibody binding fragments thereof. The light chains of theimmunoglobulin may be of type kappa or lambda. In one embodiment, theantibody molecule is glycosylated. An antibody molecule can befunctional for antibody dependent cytotoxicity and/orcomplement-mediated cytotoxicity, or may be non-functional for one orboth of these activities. An antibody molecule can be an intact antibodyor an antigen-binding fragment thereof.

Antibody molecules include “antigen-binding fragments” of a full lengthantibody, e.g., one or more fragments of a full-length antibody thatretain the ability to specifically bind to an HA target of interest.Examples of binding fragments encompassed within the term“antigen-binding fragment” of a full length antibody include (i) a Fabfragment, a monovalent fragment consisting of the VL, VH, CL and CH1domains; (ii) a F(ab′) or F(ab′)₂ fragment, a bivalent fragmentincluding two Fab fragments linked by a disulfide bridge at the hingeregion; (iii) an Fd fragment consisting of the VH and CH1 domains; (iv)an Fv fragment consisting of the VL and VH domains of a single arm of anantibody, (v) a dAb fragment (Ward et al., (1989) Nature 341:544-546),which consists of a VH domain; and (vi) an isolated complementaritydetermining region (CDR) that retains functionality. Furthermore,although the two domains of the Fv fragment, VL and VH, are coded for byseparate genes, they can be joined, using recombinant methods, by asynthetic linker that enables them to be made as a single protein chainin which the VL and VH regions pair to form monovalent molecules knownas single chain Fv (scFv). See e.g., Bird et al. (1988) Science242:423-426; and Huston et al. (1988) Proc. Natl. Acad. Sci. USA85:5879-5883. Antibody molecules include diabodies.

As used herein, an antibody refers to a polypeptide, e.g., a tetramericor single chain polypeptide, comprising the structural and functionalcharacteristics, particularly the antigen binding characteristics, of animmunoglobulin. Typically, a human antibody comprises two identicallight chains and two identical heavy chains. Each chain comprises avariable region.

The variable heavy (VH) and variable light (VL) regions can be furthersubdivided into regions of hypervariability, termed “complementaritydetermining regions” (“CDR”), interspersed with regions that are moreconserved, termed “framework regions” (FR). Human antibodies have threeVH CDRs and three VL CDRs, separated by framework regions FR1-FR4. Theextent of the FRs and CDRs has been precisely defined (see, Kabat, E.A., et al. (1991) Sequences of Proteins of Immunological Interest, FifthEdition, U.S. Department of Health and Human Services, NIH PublicationNo. 91-3242; and Chothia, C. et al. (1987) J. Mol. Biol. 196:901-917).Kabat definitions are used herein. Each VH and VL is typically composedof three CDRs and four FRs, arranged from amino-terminus tocarboxyl-terminus in the following order: FR1, CDR1, FR2, CDR2, FR3,CDR3, FR4.

The heavy and light immunoglobulin chains can be connected by disulfidebonds. The heavy chain constant region typically comprises threeconstant domains, CH1, CH2 and CH3. The light chain constant regiontypically comprises a CL domain. The variable region of the heavy andlight chains contains a binding domain that interacts with an antigen.The constant regions of the antibodies typically mediate the binding ofthe antibody to host tissues or factors, including various cells of theimmune system (e.g., effector cells) and the first component (Clq) ofthe classical complement system.

The term “immunoglobulin” comprises various broad classes ofpolypeptides that can be distinguished biochemically. Those skilled inthe art will appreciate that heavy chains are classified as gamma, mu,alpha, delta, or epsilon (γ, μ, α, δ, ε) with some subclasses among them(e.g., γ1-γ4). It is the nature of this chain that determines the“class” of the antibody as IgG, IgM, IgA IgD, or IgE, respectively. Theimmunoglobulin subclasses (isotypes) e.g., IgG1, IgG2, IgG3, IgG4, IgA1,etc. are well characterized and are known to confer functionalspecialization. Modified versions of each of these classes and isotypesare readily discernable to the skilled artisan in view of the instantdisclosure and, accordingly, are within the scope of the instantdisclosure. All immunoglobulin classes are clearly within the scope ofthe present disclosure. Light chains are classified as either kappa orlambda (κ, λ). Each heavy chain class may be bound with either a kappaor lambda light chain.

Suitable antibodies include, but are not limited to, monoclonal,monospecific, polyclonal, polyspecific, human antibodies, primatizedantibodies, chimeric antibodies, bi-specific antibodies, humanizedantibodies, conjugated antibodies (i.e., antibodies conjugated or fusedto other proteins, radiolabels, cytotoxins), Small ModularImmunoPharmaceuticals (“SMIPs™”), single chain antibodies, cameloidantibodies, and antibody fragments.

In some embodiments, an antibody is a humanized antibody. A humanizedantibody refers to an immunoglobulin comprising a human framework regionand one or more CDR's from a non-human, e.g., mouse or rat,immunoglobulin. The immunoglobulin providing the CDR's is often referredto as the “donor” and the human immunoglobulin providing the frameworkoften called the “acceptor,” though in some embodiments, no source or noprocess limitation is implied. Typically a humanized antibody comprisesa humanized light chain and a humanized heavy chain immunoglobulin.

An “immunoglobulin domain” refers to a domain from the variable orconstant domain of immunoglobulin molecules. Immunoglobulin domainstypically contain two β-sheets formed of about seven β-strands, and aconserved disulphide bond (see, e.g., A. F. Williams and A. N. Barclay(1988) Ann. Rev. Immunol. 6:381-405).

As used herein, an “immunoglobulin variable domain sequence” refers toan amino acid sequence that can form the structure of an immunoglobulinvariable domain. For example, the sequence may include all or part ofthe amino acid sequence of a naturally-occurring variable domain. Forexample, the sequence may omit one, two or more N- or C-terminal aminoacids, internal amino acids, may include one or more insertions oradditional terminal amino acids, or may include other alterations. Inone embodiment, a polypeptide that comprises an immunoglobulin variabledomain sequence can associate with another immunoglobulin variabledomain sequence to form a target binding structure (or “antigen bindingsite”), e.g., a structure that interacts with the target antigen.

As used herein, the term antibodies comprises intact monoclonalantibodies, polyclonal antibodies, single domain antibodies (e.g., sharksingle domain antibodies (e.g., IgNAR or fragments thereof)),multispecific antibodies (e.g., bi-specific antibodies) formed from atleast two intact antibodies, and antibody fragments so long as theyexhibit the desired biological activity. Antibodies for use herein maybe of any type (e.g., IgA, IgD, IgE, IgG, or IgM).

The antibody or antibody molecule can be derived from a mammal, e.g., arodent, e.g., a mouse or rat, horse, pig, or goat. In embodiments, anantibody or antibody molecule is produced using a recombinant cell. Insome embodiments an antibody or antibody molecule is a chimericantibody, for example, from mouse, rat, horse, pig, or other species,bearing human constant and/or variable regions domains.

A binding agent, as used herein, is an agent that bind, e.g.,specifically binds, a target antigen, e.g., HA. Binding agents of theinvention share sufficient structural relationship with anti-HA antibodymolecules disclosed herein to support specific binding to HA, and insome embodiments, other functional properties of an anti-HA antibodymolecule disclosed herein. In some embodiments, a binding agent willexhibit a binding affinity at of at least 10, 20, 30, 40, 50, 60, 70,80, or 90% of an antibody molecule disclosed herein, e.g., an antibodymolecule with which it shares, significant structural homology, e.g.,CDR sequences. Binding agents can be naturally occurring, e.g., as aresome antibodies, or synthetic. In an embodiment a binding agents is apolypeptide, e.g., an antibody molecule, e.g., an antibody. While somebinding agents are antibody molecules, other molecules, e.g., otherpolypeptides, can also function as binding agents. Polypeptide bindingagents can be monomeric or multimeric, e.g., dimeric, trimeric, ortetrameric and can be stabilized by intra- or interchain bonds, e.g.,disulfide bonds. They can contain natural or non-naturally occurringamino acid residues. In some embodiments, binding agents are antibodymolecules, or other polypeptides, that present one or more CDRs ofantibody molecules disclosed herein or that otherwise mimic thestructure of an antibody molecule disclosed herein. Binding agents canalso comprise aptamers, nucleic acids or other molecular entities. Abinding agent can be developed in a variety of ways, e.g., byimmunization, by rational design, screening of random structures, or acombination of those or other approaches. Typically a binding agent willact by making contact with substantially the same epitope as an antibodymolecule disclosed herein, e.g., an antibody molecule with which itshares, significant structural homology, e.g., CDR sequences. A bindingagent can interact with amino acids, saccharides, or combinationsthereof. Polypeptides other than antibodies can be used as a scaffold topresent sequence, e.g., one or more, or a complete set of heavy chainand/or light chain CDRs, disclosed herein. Exemplary scaffolds includeadnectin, zinc finger DNA-binding proteins. protein A, lipoclins,ankryin consensus repeat domain, thioredoxin, anticalins, centyrin,avimer domains, ubiquitin, peptidomimetics, stapled peptides,cystine-knot miniproteins, and IgNARs. In some embodiments, a bindingagent is or comprises a nucleic acid, e.g., DNA, RNA or mixturesthereof. In some embodiments, a binding agent, e.g., a nucleic acid,shows secondary, tertiary, or quaternary structure. In some embodimentsa binding agent, e.g., a nucleic acid, forms a structure that mimics thestructure of an antibody molecule disclosed herein.

A broad spectrum binding agent, e.g., antibody molecule, as used herein,binds, a plurality of different HA molecules, and optionally neutralizesviruses comprising the different HA molecules. In an embodiment, itbinds a first HA and binds a second HA from influenza A Group 1, andoptionally neutralizes viruses comprising the first or second HAmolecules. In an embodiment, it binds a first HA from an influenza AGroup 1 virus, and binds a second HA from an influenza A Group 2 virus,and optionally neutralizes viruses comprising the different HAmolecules. In an embodiment, it binds a first HA from an influenza AGroup 1 or 2 virus and binds a HA from an influenza B virus, andoptionally neutralizes viruses comprising the different HA molecules. Inan embodiment, it binds, and in embodiments neutralizes, at least twodifferent clades or clusters of virus, e.g., from different Groups. Insome embodiments, it binds, and in some embodiments neutralizes, all orsubstantially all strains of Group 1 an/or Group 2 disclosed herein. Inan embodiment, a binding agent, e.g., antibody molecule, binds, and insome embodiments, neutralizes: at least one strain from the Group 1 H1,e.g., H1a or H1b, cluster and at least one strain from the Group 2 H3 orH7 cluster. In an embodiment, a binding agent, e.g., antibody molecule,binds, and in some embodiments, neutralizes: at least one strain fromthe Group 1 H1, e.g., H1a or H1b, cluster and at least one influenza Bstrain. In an embodiment, a binding agent, e.g., antibody molecule,binds, and in some embodiments, neutralizes: at least one strain fromthe Group 2 H3 or H7 cluster and at least one influenza B strain. In anembodiment, a binding agent, e.g., antibody molecule, binds, and in someembodiments, neutralizes: at least one strain from the Group 1 H1, e.g.,H1a or H1b, cluster, at least one strain from the Group 2 H3 or H7cluster, and at least one influenza B strain. In some embodiments,binding agent, e.g., antibody molecule, binds, and optionallyneutralizes or mediate infection of particular hosts, e.g., avian,camel, canine, cat, civet, equine, human, mouse, swine, tiger, or othermammal or bird.

The term “combination therapy”, as used herein, refers to administrationof a plurality of agents, e.g., wherein at least one binding agent,e.g., antibody molecule, disclosed herein is administered to a subject,e.g., a human subject. The introduction of the agents into the subjectcan be at different times. In some embodiments, the agents areadministered in overlapping regimens, or such that the subject issimultaneously exposed to both agents, or such that the response of thesubject is better than would be seen with either agent administeredalone.

As used herein, an “escape mutant” is a mutated influenza strain that isresistant to neutralization by an anti-HA antibody molecule describedherein. In some embodiments, an escape mutant is resistant toneutralization with a binding agent, e.g., antibody molecule, but itsparent strain is neutralized by the binding agent, e.g., antibodymolecule. Resistance can be tested by various methods, including, butnot limited to, genotypic testing (e.g., Sanger sequencing/nestedPCR-baseline and last qPCR sample (Ct<32)), and phenotypic testing(e.g., plaque reduction on primary sample, e.g., ViroSpot™ assay (e.g.,virus titration−last post-baseline≥2 Log₁₀ TCID₅₀/mL) or IC50 singlepassage sample (e.g., antibody titration−last post-baseline≥1 Log₁₀TCID₅₀/mL).

As used herein, “pandemic influenza” refers to a new viral strain thatarises due to human adaptation of an influenza strain by mutation or byemergence of a strain by reassortment of different strains of influenzaA. The resulting pandemic strain is significantly different fromprevious strains and most people will have little or no pre-existingimmunity. Symptoms and complications may be more severe and morefrequent than those typical of seasonal influenza. Examples of pastpandemic flu viruses include, e.g., the 2009 H1N1 ‘swine flu,’ the1957-58 H2N2 ‘Asian flu’ and the 1968 H3N2 influenza strains.

The terms “purified” and “isolated” as used herein in the context of anantibody molecule, e.g., an antibody, or generally a polypeptide,obtained from a natural source, refers to a molecule which issubstantially free of contaminating materials from the natural source,e.g., cellular materials from the natural source, e.g., cell debris,membranes, organelles, the bulk of the nucleic acids, or proteins,present in cells. Thus, a polypeptide, e.g., an antibody molecule, thatis isolated includes preparations of a polypeptide having less thanabout 30%, 20%, 10%, 5%, 2%, or 1% (by dry weight) of cellular materialsand/or contaminating materials. The terms “purified” and “isolated” whenused in the context of a chemically synthesized species, e.g., anantibody molecule, refers to the species which is substantially free ofchemical precursors or other chemicals which are involved in thesyntheses of the molecule.

A preparation of binding agents, e.g., antibody molecules, as usedherein, comprises a plurality of molecules of a binding agent, e.g.,antibody molecule, described herein. In some embodiments, the bindingagent, e.g., antibody molecule, makes up at least 60, 70, 80, 90, 95,98, 99, 99.5 or 99.9%, of the preparation, or of the active ingredientsof the preparation, by weight or number. In some embodiments, thatbinding agent is an antibody molecule which makes up at least 60, 70,80, 90, 95, 98, 99, 99.5 or 99.9%, of the preparation, or of the activeingredients, or polypeptide ingredients, or antibody molecules, of thepreparation, by weight or number. In some embodiments, the binding agentis an antibody molecule and the preparation contains no more than 30,20, 10, 5, 2, 1, or 0.5%, by weight or number, of a contaminant, e.g., areactant, solvent, precursor or other species, from the source, or usedin the preparation, of the antibody molecule, e.g., a species from acell, reaction mixture, or other system used to produce the antibodymolecule.

As used herein, the term “prevent infection” means that a subject (e.g.,a human) is less likely to be infected by influenza if the subjectreceives the antibody prior to (e.g., 1 day, 2 days, 1 week, 2 weeks, 3weeks, or 1 month of more) before being exposed to influenza.

As used herein, “seasonal influenza” is a strain that is identical orclosely related to strains that have been circulating in the humanpopulation in recent years and therefore most people are at leastpartially immune to it. Such a strain is not likely to cause severedisease. Symptoms can include fever, cough, runny nose, and muscle pain,and in rare cases, death can result from complications, such aspneumonia. Outbreaks follow predictable seasonal patterns, annually, andusually in fall and winter and in temperate climates. Infection due toseasonal influenza is commonly referred to as the flu.

As used herein, specific binding, means that a binding agent, e.g., anantibody molecule, binds its antigen with a K_(D) of equal to or lessthan 10⁻⁵. In some embodiments, the antibody binds it's antigen with aK_(D) of equal to or less than 10⁻⁶, 10⁻⁷, 10⁻⁸, 10⁻⁹, 10⁻¹⁰, 10⁻¹¹, or10⁻¹².

As used herein, the term “therapeutically effective amount” refers to anamount of a therapeutic agent, e.g., a binding agent, e.g., an antibodymolecule, which results in a positive outcome for the subject. In someembodiments, it can be statistically correlated with therapeutic effector benefit, e.g., the lessening or prevention of a manifestation of aneffect or a symptom, when administered to a population of subjects. Insome embodiments, it is an amount that also provides a preselected, orreasonable, benefit/risk ratio. In some embodiments, it is an amounteffective to reduce the incidence and/or severity of and/or to delayonset of one or more features, symptoms, or characteristics of adisease, disorder, or condition. A therapeutically effective amount iscan be administered in a dosing regimen that may comprise one ormultiple unit doses.

As used herein, the term “treat infection” means that a subject (e.g., ahuman) who has been infected with an influenza and experiences symptomsof the influenza (e.g., the flu), will in some embodiments, suffer lesssevere symptoms and/or will recover faster when the antibody molecule isadministered than if the antibody is never administered. In someembodiments, when an infection is treated, an assay to detect virus inthe subject will detect less virus after effective treatment for theinfection. For example, a diagnostic assay using an antibody molecule,such as an antibody molecule described herein, will detect less or novirus in a biological sample of a patient after administration of anantibody molecule for the effective treatment of the viral infection.Other assays, such as PCR (e.g., qPCR) can also be used to monitortreatment in a patient, to detect the presence, e.g., decreased presence(or absence) after treatment of viral infection in the patient.Treatment can, e.g., partially or completely alleviate, ameliorate,relive, inhibit, reduce the severity of, and/or reduces incidence andoptionally, delay onset of, one or more manifestations of the effects orsymptoms, features, and/or causes of a particular disease, disorder,and/or condition (e.g., influenza). In some embodiments, treatment is ofa subject who does not exhibit signs of the relevant disease, disorderand/or condition and/or of a subject who exhibits only early signs ofthe disease, disorder, and/or condition. In some embodiments, treatmentis of a subject who exhibits one or more established signs of therelevant disease, disorder and/or condition. In some embodiments,treatment is of a subject diagnosed as suffering from influenza.

Calculations of “homology” or “sequence identity” or “identity” betweentwo sequences (the terms are used interchangeably herein) can beperformed as follows. The sequences are aligned for optimal comparisonpurposes (e.g., gaps can be introduced in one or both of a first and asecond amino acid or nucleic acid sequence for optimal alignment andnon-homologous sequences can be disregarded for comparison purposes).The optimal alignment is determined as the best score using the GAPprogram in the GCG software package with a Blossum 62 scoring matrixwith a gap penalty of 12, a gap extend penalty of 4, and a frameshiftgap penalty of 5. The amino acid residues or nucleotides atcorresponding amino acid positions or nucleotide positions are thencompared. When a position in the first sequence is occupied by the sameamino acid residue or nucleotide as the corresponding position in thesecond sequence, then the molecules are identical at that position (asused herein amino acid or nucleic acid “identity” is equivalent to aminoacid or nucleic acid “homology”). The percent identity between the twosequences is a function of the number of identical positions shared bythe sequences.

Hemagglutinin (HA) Polypeptides and Influenza

Influenza viruses are negative sense, single-stranded, segmented RNAenvelope viruses. Two glycoproteins, a hemagglutinin (HA) polypeptideand a neuraminidase (NA) polypeptide, are displayed on the outer surfaceof the viral envelope. There are several Influenza A subtypes, labeledaccording to an H number (for the type of hemagglutinin) and an N number(for the type of neuraminidase). There are 17 different H antigens (H1to H17) and nine different N antigens (N1 to N9). Influenza strains areidentified by a nomenclature based on the number of the strain's HApolypeptide and NA polypeptide subtypes, for example, H1N1, H1N2, H1N3,H1N4, H1N5, and the like.

HA is the major viral surface glycoprotein that mediates binding andentry of the virus into host cells and is a primary target ofneutralizing antibody responses. HA is a trimer of three identicalmonomers. Each monomer is synthesized as a precursor, HA₀, that isproteolytically processed into two disulfide-bonded polypeptide chains,HA₁ and HA₂. The ectodomain of this protein has (i) a globular headdomain possessing receptor binding activity and major antigenicdeterminants, (ii) a hinge region, and (iii) a stem region where asequence critical for fusion, the fusion peptide, is located. The viralreplication cycle is initiated when the virion attaches via its surfacehemagglutinin proteins to sialylated glycan receptors on the host celland enters the cell by endocytosis. The acidic environment in theendosome induces conformational changes in HA that expose the fusionpeptide hidden within the stem region of the trimer. The exposed fusionpeptide mediates the fusion of the viral and target cell membranesresulting in the release of the viral ribonucleoprotein into the cellcytoplasm.

Influenza A hemagglutinin subtypes have been divided into two maingroups and four smaller clades, and these are further divided intoclusters. Group 1 influenza A strains are divided into 3 clades: (i) H8,H9 and H12 (“the H9 cluster”); (ii) H1, H2, H5, H6 and H17 (“the H1acluster”); and (iii) H11, H13 and H16 (“the H1b cluster”). Group 2strains are divided into 2 clades: (i) H3, H4 and H14 (“the H3cluster”); and (ii) H7, H10 and H15 (“the H7 cluster”). The H1b and theH1a clusters are classified together as the H1 cluster. The different HAsubtypes do not necessarily share strong amino acid sequence identity,but their overall 3D structures are similar.

Of the 17 HA polypeptide subtypes, only 3 (H1, H2 and H3) have adaptedfor human infection. These subtypes have in common an ability to bindalpha 2,6 sialylated glycans. In contrast, their avian counterpartspreferentially bind to alpha 2,3 sialylated glycans. HA polypeptidesthat have adapted to infect humans (e.g., of HA polypeptides from thepandemic H1N1 (1918) and H3N2 (1967-68) influenza subtypes) have beencharacterized by an ability to preferentially bind to α2,6 sialylatedglycans in comparison with their avian progenitors that preferentiallybind to α2,3 sialylated glycans (see, e.g., Skehel & Wiley, Annu RevBiochem, 69:531, 2000; Rogers, & Paulson, Virology, 127:361, 1983;Rogers et al., Nature, 304:76, 1983; Sauter et al., Biochemistry,31:9609, 1992

Further, HA polypeptides that mediate infection of humans preferentiallybind to umbrella topology glycans over cone topology glycans (see, e.g.,U.S. 2011/0201547). Without wishing to be bound by any particulartheory, it has been proposed that the ability to infect human hostscorrelates less with binding to glycans of a particular linkage, andmore with binding to glycans of a particular topology, even thoughcone-topology glycans may be α2,6 sialylated glycans. In has beendemonstrated that HA polypeptides that mediate infection of humans bindto umbrella topology glycans, often showing preference for umbrellatopology glycans over cone topology glycans (See, for example, U.S.Application Publication Nos. 2009/0269342, 2010/0061990, 2009/0081193,and 2008/0241918, and International Publication No. WO2008/073161).

Mature HA polypeptides include three domains, (i) a globular domain(a.k.a., the head domain) consists mainly of the HA1 peptide andcontains the receptor (sialylated glycoproteins)-binding region, (ii) astalk domain (HA1 and HA2) where the membrane fusion peptide resides,and (iii) a transmembrane domain (HA2) that anchors hemagglutinin to theviral envelope. A set of amino acids in the interface of the HA1 and HA2peptides is highly conserved across all influenza subtypes. The HA1/HA2membrane proximal region (MPER), including a canonical alpha-helix, isalso highly conserved across influenza subtypes.

HA polypeptides interact with the surface of cells by binding to aglycoprotein receptor, known as the HA receptor. Binding of an HApolypeptide to an HA receptor is predominantly mediated by N-linkedglycans on the HA receptors. HA polypeptides on the surface of flu virusparticles recognize sialylated glycans that are associated with HAreceptors on the surface of the cellular host. Following replication ofviral proteins and genome by the cellular machinery, new viral particlesbud from the host to infect neighboring cells.

Currently, vaccines are administered to subjects, e.g., humans, toprevent the flu, e.g., to prevent infection or to minimize the effectsof an infection with influenza virus. Traditional vaccines contain acocktail of antigens from various strains of influenza and areadministered to humans to prevent the human from getting infected withthe virus. HA is the main target of influenza A-neutralizing antibodies,and HA undergoes continuous evolution driven by the selective pressureof the antibody response, which is primarily directed against themembrane-distal receptor-binding subdomain of the HA polypeptide. Thesubject, however, is protected only from strains that are identical to,or closely related to, the strains from which the antigens in thecocktail were derived. The human is still most vulnerable to infectionby other strains of the flu that were not included in the cocktail. Oneof the advantages of the antibodies provided herein is their ability tobind an epitope of HA that is conserved across multiple strains ofinfluenza A, and in some embodiments, influenza B. Thus, administrationof an anti-HA antibody described herein will be more effective toprotect an individual from infection from a broader spectrum ofinfluenza (e.g., influenza A and, in some embodiments, influenza B) andconditions associate thereof (e.g., secondary infections, e.g.,secondary bacterial infections). Further, the antibodies are effectivein treating a subject after infection has occurred.

Anti-HA Antibody Molecules

Binding agents, and in particular, the antibody molecules describedherein, can bind to influenza A viruses from both Group 1 and Group 2,and in some embodiments also bind influenza B viruses. For example, theantibody molecules described herein can bind to an HA polypeptide on atleast 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 or 11 strains from Group 1, and canalso bind to an HA polypeptide on at least 1, 2, 3, 4, 5, or 6 strainsfrom Group 2. In another example, the antibody molecules describedherein can bind to an HA polypeptide on an influenza strain from atleast 1, 2 or 3 clades from Group 1, and can also bind to an HApolypeptide on an influenza strain from one or both clades of Group 2.The antibody molecules described herein inhibit cell entry and thustargeting an early step in the infection process.

The binding agents, and in particular, the antibody molecules featuredin the disclosure, can be effective to treat or prevent infection byseasonal or pandemic influenza strains. The binding agents, and inparticular the antibody molecules described herein, can be characterizedby their ability to prevent or treat a Group 1 or a Group 2 strain ofinfluenza A viruses or, in some embodiments, a strain of influenza Bviruses. The binding agents, and in particular the antibody moleculesfeatured in the disclosure, are effective to prevent or treat infectionby one or more strains of Group 1, one or more strains of Group 2, andalso one or more strains of influenza B viruses. In an embodiment, thebinding agent is used to treat or prevent an influenza virus infectioncaused by an influenza virus chose from an H1N1 virus, an H3N2 virus, anH7N9 virus, or a combination thereof.

The binding agents, and in particular the antibody molecules can beeffective to treat the infection when administered the same day as thesubject is exposed, or when administered, e.g., 1 day, 2 days, 3 days, 4days or later after infection, or upon a first symptom experienced bythe patient. In an embodiment, the antibody molecule does not cause anantibody dependent enhancement (ADE) in the subject, e.g., as determinedby a method described herein. In an embodiment, the antibody moleculedoes not cause viral resistance, e.g., as determined by a methoddescribed herein.

Strains

The antibody molecules described herein are effective to treat one ormore influenza strains of Group 1, one or more influenza strains ofGroup 2, and also one or more influenza B strains, and specific isolateswithin these strains. Certain antibody molecules may be more effectivefor treatment of certain isolates than other isolates. Exemplaryinfluenza strains and isolates are described in the below Table 1.Affinity can also be in reference to a particular isolate of a givenGroup 1 or Group 2 strain for influenza A viruses or a strain forinfluenza B viruses. Exemplary isolates are as provided in the aboveTable 1. Other exemplary influenza virus strains and isolates are alsodescribed herein, e.g., in FIG. 18.

TABLE 1 Exemplary Influenza Strains and Isolates Type Group HA typeIsolate A 1 H1N1 A/PR/8/34 (aka PR-8) A/Solomon Islands/03/06 A/SolomonIslands/20/1999 A/California/07/2009 A/New Caledonia/20/99A/Bangkok/10/83 A/Yamagata/120/86 A/Osaka/930/88 A/Suita/1/89A/California/04/2009 A 1 H2N2 A/Okuda/57 A/Adachi/2/57 A/Kumamoto/1/65A/Kaizuka/2/65 A/Izumi/5/65 A/Chicken/PA/2004 A 1 H5N1 A/Vietnam/1203/04A/Duck/Singapore/3/97 A/Duck/MN/1525/81 A 1 H9N2 A/Hong Kong/1073/2004A/Swine/Hong Kong/9/98 A/Guinea fowl/HK/WF10/99 A 1 H16N3 A/black headedgull/Mongolia/1756/2006 A 2 H3N2 X-31 A/Victoria/3/75 A/Wyoming/03/2003A/Wisconsin/67/2005 A/Brisbane/10/2007 A/California/7/2004 A/NewYork/55/2004 A/Moscow/10/1999 A/Aichi/2/68 A/Beijing/32/92/X-117A/Fukuoka/C29/85 A/Sichuan/2/87 A/Ibaraki/1/90 A/Suita/1/90A/Perth/16/2009 A/Uruguay/716/2007 A/Fujian/411/2003 A/Panama/2007/99A/Shangdong/09/93 A 2 H7N7 A/Netherlands/219/2003 B B/Wisconsin/1/2010

Mechanisms of Inhibition

While not being limited by a specific mechanism, HA specific antibodiescan inhibit infection by numerous methods, such as by blocking viralattachment to sialic acid residues on surface proteins on host cells, byinterfering with the structural transition of HA that triggers fusionactivity in the endosome, or by simultaneously inhibiting attachment andvirus-cell fusion. In some embodiments, antibody molecules featuredherein bind an epitope at the HA trimer interface. Structural changes atthe trimer interface are important for fusion of the viral membrane andthe endocytic membrane, and the antibody molecules described hereininterfere with this critical step of infection. Assays to measurefusogenic activity of HA are known in the art. For example, one fusionassay measures syncytia formation, which occurs in cell-cell fusionevents. Cells that express and display an influenza viral strain HA canbe used in the assay. Membrane-anchored hemagglutinin in these cells isinduced to convert to the fusion conformation by a brief (e.g., 3minute) exposure to low pH (e.g., pH 5). A 2-3-hour incubation periodfollows to allow the cells to recover and fuse to form syncytia. Anuclear stain can be used to aid in the visualization of these fusionproducts, and their count is used as a gauge of fusion activity. Acandidate anti-HA antibody can be added either before or after the lowpH treatment to determine at which stage of the fusion process theantibody interferes.

Another type of fusion assay monitors content mixing. To measure contentmixing, host cells (e.g., erythrocytes) are loaded with a dye (e.g.,Lucifer yellow) to determine whether the contents of HA-bound host cellscould be delivered to HA-expressing cells after exposure tofusion-inducing conditions (e.g., low pH, such as pH less than 6 or pHless than 5). If the dye fails to mix with the contents of the hostcells, then the conclusion can be made that fusion is inhibited. See,e.g., Kemble et al., J. Virol. 66:4940-4950, 1992. In another example, afusion assay is performed by monitoring lipid mixing. The lipid mixingassay can be performed by labeling host cells (e.g., erythrocytes) witha fluorescent dye (e.g., R18 (octadecylrhodamine)) or dye pairs (e.g.,CPT-PC/DABS-PC) (for fluorescence resonance energy transfer), exposingthe host cells and HA-expressing cells to fusion-inducing conditions,and assaying for fluorescence dequenching (FDQ). Lipid mixing leads todilution of the label into the viral envelope and a consequentdequenching. A lag in dequenching or the absence of dequenching isindicative of membrane fusion inhibition. See, e.g., Kemble et al., J.Virol. 66:4940-4950, 1992; and Carr et al., Proc. Natl. Acad. Sci.94:14306-14313, 1997.

Escape Mutants

In some embodiments, influenza strains will rarely if ever produceescape mutants when contacted with the featured antibody molecules.Escape mutants can be identified by methods known in the art. Forexample, an antibody featured in the disclosure will not produce anescape mutant when the cells are infected with the virus under prolongedor repeated exposure to anti-HA antibodies featured in the disclosure.

One exemplary method includes infection of cells (e.g. MDCK cells) witha fixed amount of influenza A viral particles in the presence of theantibody at a concentration known to attenuate infection rates by 50%.Viral progeny collected after each passaging is used to infect a freshcell culture in the presence of the same or greater concentration of theantibody. After multiple cycles of infection, e.g., after 15 cycles, 12cycles, 11 cycles, 10 cycles, 9 cycles, 8 cycles, 7 cycles, 6 cycles, or5 cycles, of infection under these conditions, the HA nucleotidesequence extracted from 20 viral plaque picks is evaluated forenrichment for mutations that renders the viral isolate resistant toneutralization by the antibody (an escape mutant). If no mutants withreduced sensitivity to the antibody are detected after the multiplerounds of selection, e.g., after 11 rounds, 10 rounds, or 9 rounds ofselection, the antibody is determined to be resistant to escapemutations (see, e.g., Throsby et al. (2008) PLoS One, volume 3, e3942).

In another example, an assay that measures minimum inhibitoryconcentration (MIC) of the neutralizing antibody can be used to identifyescape mutants. The MIC of an antibody molecule is the lowestconcentration of an antibody molecule that can be mixed with virus toprevent infection of cell culture with influenza. If escape mutantsarise within a viral population, then the MIC of a particular antibodywill be observed to increase with increased rounds of propagation underthe antibody selective pressure, as the proportion of the viralparticles that carry the resistance mutation within the populationincreased. Influenza escape mutants rarely if ever evolve in response toan anti-HA antibody molecule described herein, and therefore the MICwill stay the same over time.

Another assay suitable for monitoring for the development of escapemutants is a Cytopathic Effect (CPE) assay. A CPE assay monitors theability of an antibody to neutralize (i.e., prevent infection by) aninfluenza strain. A CPE assay provides the minimal concentration ofantibody required in cell culture to neutralize the virus. If escapemutants arise, than the CPE of a particular antibody will increase overtime, as the antibody becomes less effective at neutralizing the virus.Viral strains rarely if ever produce escape mutants in response to ananti-HA antibody molecule described herein, and therefore the CPE willstay essentially the same over time.

Quantitative polymerase chain reaction (qPCR) can also be used tomonitor for the development of escape mutants. qPCR is useful to monitorthe ability of an antibody to neutralize (i.e., prevent infection by) aninfluenza strain. If an antibody effectively neutralizes a virus, thenqPCR performed on cell culture samples will not detect presence of viralgenomic nucleic acid. If escape mutants arise, than over time, qPCR willamplify more and more viral genomic nucleic acid. Escape mutants rarelyif ever develop in response to an anti-HA antibody molecule describedherein, and therefore qPCR will rarely if ever detect viral genomicnucleic acid, even after the passage of time.

Binding and Affinity

In some embodiments, the binding agents, particularly antibodymolecules, featured herein bind to two or more of the following: atleast one HA polypeptide from a Group 1 influenza strain (e.g., an H1,H2, H5, H6, H8, H9 H12, H11, H13, H16 or H17 polypeptide); at least oneHA polypeptide from a Group 2 influenza strain (e.g., an H3, H4, H14,H7, H10, or H15 polypeptide); and at least one HA polypeptide from aninfluenza B strain. In an embodiment, a binding agent, e.g., an antibodymolecule, has a K_(D) for an HA from a Group 1 influenza strain (e.g.,an H1, H2, H5, H6, H8, H9 H12, H11, H13, H16 or H17 polypeptide) ofequal to or less than 10⁻⁶, 10⁻⁷, 10⁻⁸, 10⁻⁹, 10⁻¹⁰, 10⁻¹¹, or 10⁻¹². Inan embodiment, a binding agent, e.g., an antibody molecule, has a K_(D)for an HA from a Group 2 influenza strain (e.g., an H3, H4, H14, H7,H10, or H15 polypeptide) of equal to or less than 10⁻⁶, 10⁻⁷, 10⁻⁸,10⁻⁹, 10⁻¹⁰, 10⁻¹¹, or 10⁻¹². In an embodiment, a binding agent, e.g.,an antibody molecule, has a K_(D) for an influenza B HA of equal to orless than 10⁻⁶, 10⁻⁷, 10⁻⁸, 10⁻⁹, 10⁻¹⁰, 10⁻¹¹, or 10⁻¹². In anembodiment, a binding agent, e.g., an antibody molecule, has: a) a firstK_(D) (representing an affinity for an HA from a Group 1 influenzastrain, e.g., an H1, H2, H5, H6, H8, H9 H12, H11, H13, H16 or H17polypeptide); and b) a second K_(D) (representing an affinity for an HAfrom a Group 2 influenza strain, e.g., an H3, H4, H14, H7, H10, or H15polypeptide), wherein the first and second K_(D) are one or both of:both equal to or less than 10⁻⁸; and within 10 or 100 fold of eachother;

In an embodiment, a binding agent, e.g., an antibody molecule, has a) afirst K_(D) (representing an affinity for an H1, e.g., the H1 from anH1N1 strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004); and b) a second K_(D) (representing an affinityfor an H3 polypeptide, e.g., the H3 from an H3N2 strain, e.g.,A/Brisbane/59/2007), wherein the first and second K_(D) are one or bothof: both equal to or less than 10⁻⁸; and within 10 or 100 fold of eachother. In an embodiment, a binding agent, e.g., an antibody molecule,has: a) a first K_(D) (representing an affinity for an H1, e.g., the H1from an H1N1 strain, e.g., A/South Carolina/I/1918, A/PuertoRico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004); and b) a second K_(D)(representing an affinity for an H3 polypeptide, e.g., the H3 from anH3N2 strain, e.g., A/Brisbane/59/2007), wherein the first and secondK_(D) are one or both of: both equal to or less than 10⁻⁸; and within 10or 100 fold of each other.

In an embodiment, a binding agent, e.g., an antibody molecule, has: a) afirst K_(D) (representing an affinity for an HA from a Group 1 influenzastrain, e.g., an H1, H2, H5, H6, H8, H9 H12, H11, H13, H16 or H17polypeptide and/or an affinity for an HA from a Group 2 influenzastrain, e.g., an H3, H4, H14, H7, H10, or H15 polypeptide); and b) asecond K_(D) (representing an affinity for an influenza B HA, e.g., fromB/Wisconsin/1/2010); wherein the first and second K_(D) are one or bothof: both equal to or less than 10⁻⁸; and within 10 or 100 fold of eachother. In an embodiment, a binding agent, e.g., an antibody molecule,has: a) a first K_(D) (representing an affinity for an HA from a Group 1influenza strain, e.g., an H1, e.g., the H1 from an H1N1 strain, e.g.,A/South Carolina/I/1918, A/Puerto Rico/08/1934, or A/California/04/2009,or an H5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004,and/or an affinity for an HA from a Group 2 influenza strain, e.g., anH3 polypeptide, from an H3N2 strain, e.g., from A/Brisbane/59/2007); andb) a second K_(D) (an affinity for an influenza B HA); wherein the firstand second K_(D) are: one or both of: both equal to or less than 10⁻⁸;and within 10 or 100 fold of each other.

In one embodiment, the antibody molecule binds to at least one HApolypeptide from a Group 1 influenza strain with a higher affinity thana reference anti-HA antibody, and to at least one HA polypeptide from aGroup 2 influenza strain with a higher affinity than a reference anti-HAantibody. In another embodiment, the antibody molecule binds to at leastone HA polypeptide from an influenza A strain with a higher affinitythan a reference anti-HA antibody, and to at least one HA polypeptidefrom an influenza B strain with a higher affinity than a referenceanti-HA antibody. Exemplary reference HA antibodies include Ab 67-11(U.S. Provisional application No. 61/645,453, filed on the same date asthe present application), FI6 (F16, as used herein, refers to anyspecifically disclosed FI6 sequence in U.S. Application Publication No.2010/0080813, US Application Publication No. 2011/0274702, InternationalPublication No. WO2013/011347 or Corti et al., Science 333:850-856,2011, published online Jul. 28, 2011; FIGS. 12A to 12C of InternationalPublication No. WO2013/170139 or U.S. Application Publication No.2013/0302349), F128 (U.S. Application Publication No. 2010/0080813), andC179 (Okuno et al., J. Virol. 67:2552-1558, 1993), F10 (Sui et al., Nat.Struct. Mol. Biol. 16:265, 2009), CR9114 (Dreyfus et al., Science. 2012;337(6100):1343-1348; published online Aug. 9, 2012), and CR6261 (Ekiertet al., Science 324:246-251, 2009; published online Feb. 26, 2009).

Affinity, or relative affinity or aviditiy, can be measured by methodsknown in the art, such as by ELISA assay (Enzyme Linked ImmunosorbentAssay), Surface Plasmon Resonance (SPR, e.g., by a Biacore™ Assay), orKinExA® assay (Sapidyne, Inc.). Relative binding affinity is expressedherein according to ELISA assay. As used herein, an anti-HA antibodythat binds with “high affinity” to a Group 1 HA, to a Group 2 HA, and toan influenza B HA, can bind a Group 1 HA with a Kd less than or equal to200 pM, e.g., less than or equal to 100 pM, as measured by ELISA, canbind a Group 2 HA with a Kd less than or equal to 200 pM, e.g., lessthan or equal to 100 pM, as measured by ELISA, and can bind an influenzaB HA with a Kd less than or equal to 200 pM, e.g., less than or equal to100 pM, as measured by ELISA.

Exemplary Anti-HA Antibody Molecules

Provided herein are antibodies that have one or more CDR sequences andone or more framework (FR) sequences as shown in Table 2.

TABLE 2 Heavy and Light Chain CDR and FR Sequences for Anti-HA Antibodies CDR/FR SEQ RegionAmino Acid Sequence ID NO: HC CDR1 [S/T]Y[A/G]MH 1 HC CDR2V[I/V/L]S[Y/F]DG[S/N][Y/N] 2 [K/R]YYADSVQG HC CDR3D[S/T][R/K/Q]LR[S/T]LLYFEWLS 3 [Q/S]G[Y/L/V][F/L][N/D][P/Y] LC CDR1Q[S/T][V/L/I][T/S][Y/F/W] 4 [N/S/D]YKNYLA LC CDR1Q[S/T][V/L/I][T/S][Y/F/W] 170 [N/S/D/Q/R/E]YKNYLA LC CDR2W[A/G]S[T/A/Y/H/K/D] 5 [R/L]E[S/T] LC CDR3 QQ[Y/H]YRTPP[T/S] 6 HC FR1[E/Q]VQLLE[S/T]GGGLVKPGQSLKL 7 SCAASGFTF[S/T] HC FR2 WVRQPPGKGLEWVA 8HC FR3 RFTISRDNSKNTLYLQMNSLRAEDTAVY 9 YCAK HC FR4WG[A/Q]G[T/A][T/M][L/V]TVSS 10 LC FR1 [E/D]I[V/Q]MTQSP[D/S][S/T] 11[L/V][A/S][V/A][S/T][L/V/R] G[E/D]R[A/V][T/S]I [N/T/Q/D/R/]C[K/R]SSLC FR2 WYQQKPG[Q/K][P/A]PKLLIY 12 LC FR3 GVP[D/E/S]RFSGSGSGTDFTLTISS 13LQ[A/P]ED[V/F/K/D]A[V/T]YYC LC FR4 FG[G/Q/T/S/N]GTK[L/V][D/E]IK 14

In one embodiment, the anti-HA antibody comprises a heavy chain and/or alight chain as defined in Table 3 below. The amino acid sequences of thevariable heavy and light chains of Table 3 are provided in FIGS. 2 and3, respectively, or in FIG. 17, of International Publication No.WO2013/170139 or U.S. Application Publication No. 2013/0302349.

TABLE 3 Heavy and Light Chain Amino Acid Sequence Designations forAnti-HA Antibodies Antibody HC SEQ ID NO: LC SEQ ID NO: 1. Ab A18 15 1528 28 2. Ab 014 16 16 29 29 3. Ab 028 16 16 30 30 4. Ab 001 17 17 31 315. Ab 002 18 18 31 31 6. Ab 003 19 19 31 31 7. Ab 009 17 17 32 32 8. Ab010 18 18 32 32 9. Ab 011 19 19 32 32 10. Ab 017 17 17 33 33 11. Ab B1818 18 33 33 12. Ab 019 19 19 33 33 13. Ab 025 17 17 34 34 14. Ab 026 1818 34 34 15. Ab 027 19 19 34 34 16. Ab 086 20 20 34 34 17. Ab 154 21 2129 29 18. Ab 155 21 21 30 30 19. Ab 157 22 22 29 29 20. Ab 159 22 22 3535 21. Ab 160 17 17 36 36 22. Ab 186 17 17 37 37 23. Ab 187 17 17 38 3824. Ab 188 17 17 39 39 25. Ab 189 17 17 40 40 26. Ab 190 17 17 41 41 27.Ab 191 17 17 42 42 28. Ab 192 17 17 43 43 29. Ab 193 17 17 44 44 30. Ab194 19 19 37 37 31. Ab 195 19 19 38 38 32. Ab 196 19 19 39 39 33. Ab 19719 19 40 40 34. Ab 198 19 19 41 41 35. Ab 199 19 19 42 42 36. Ab 200 1919 43 43 37. Ab 202 17 17 45 45 38. Ab 203 18 18 45 45 39. Ab 204 19 1945 45 40. Ab 210 23 23 45 45 41. Ab 211 17 17 46 46 42. Ab 212 18 18 4646 43. Ab 213 19 19 46 46 44. Ab 219 23 23 46 46 45. Ab A001 24 24 47 4746. Ab A002 24 24 48 48 47. Ab A003 24 24 49 49 48. Ab 004 25 25 47 4749. Ab 005 25 25 48 48 50. Ab 006 25 25 49 49 51. Ab 007 26 26 47 47 52.Ab 008 26 26 48 48 53. Ab A009 26 26 49 49 54. Ab A010 24 24 50 50 55.Ab A011 24 24 51 51 56. Ab 012 25 25 50 50 57. Ab 013 25 25 51 51 58. AbA14 26 26 50 50 59. Ab 015 26 26 51 51 60. Ab 016 27 27 47 47 61. AbA017 27 27 48 48 62. Ab C18 27 27 49 49 63. Ab A019 27 27 50 50 64. Ab031 24 24 45 45 65. Ab 032 25 25 45 45 66. Ab 033 26 26 45 45 67. Ab 03427 27 45 45 68. Ab 037 24 24 46 46 69. Ab 038 25 25 46 46 70. Ab 039 2626 46 46 71. Ab 040 27 27 46 46 72. Ab 043 25 25 60 60 73. Ab 044 25 2552 52 74. Ab 045 25 25 57 57 75. Ab 046 25 25 59 59 76. Ab 047 25 25 5555 77. Ab 048 25 25 58 58 78. Ab 049 25 25 54 54 79. Ab 050 25 25 56 5680. Ab 051 25 25 53 53 81. Ab 052 25 25 61 61 82. Ab 067 25 25 153 15383. Ab 068 25 25 154 154 84. Ab 069 25 25 155 155 85. Ab 070 25 25 156156 86. Ab 071 162 162 52 52 87. Ab 072 163 163 52 52 88. Ab 073 25 25165 165 89. Ab 074 25 25 166 166 90. Ab 075 25 25 167 167 91. Ab 076 2525 168 168 92. Ab 077 25 25 169 169 93. Ab 078 164 164 52 52 94. Ab 079164 164 155 155 95. Ab 080 164 164 166 166 96. Ab 081 164 164 169 169

In one embodiment, the anti-HA antibody comprises a heavy chain asdefined in Table 4A below, and/or a light chain as defined in Table 4Abelow.

TABLE 4A Heavy and Light Chain Amino Acid Sequence Designations HC SEQID NO: LC SEQ ID NO: 15 15 28 28 16 16 29 29 17 17 30 30 18 18 35 35 1919 31 31 21 21 32 32 22 22 33 33 20 20 34 34 23 23 36 36 24 24 45 45 2525 46 46 26 26 37 37 27 27 38 38 Hc consensus 161 39 39 (HC161) 162 16240 40 163 163 41 41 164 164 42 42 43 43 44 44 47 47 48 48 49 49 50 50 5151 52 52 53 53 54 54 55 55 56 56 57 57 58 58 59 59 60 60 61 61 153 153154 154 155 155 156 156 LC 62 consensus (LC62) 165 165 166 166 167 167168 168 169 169

In one embodiment, an antibody featured in the disclosure comprises aheavy chain sequence as defined in Table 4A and a light chain sequenceas defined in Table 4A.

In one embodiment, an antibody featured in the disclosure comprises aheavy chain sequence as defined herein, e.g., in Table 4A, where adipeptide is fused to the N-terminus. Typically, the dipeptide isisoleucine-aspartic acid (Ile-Asp). In another embodiment, an antibodyfeatured in the disclosure comprises a light chain sequence as definedherein, e.g., in Table 4A, where a dipeptide is fused to the N-terminus.Typically, the dipeptide is Ile-Asp. In yet another embodiment, anantibody featured in the disclosure comprises a heavy chain comprisingan N-terminal Ile-Asp dipeptide and a light chain comprising an Ile-Aspdipeptide. In the propeptide sequence of the heavy chain or light chainpolypeptide, the Ile-Asp dipeptide occurs between the signal sequenceand FR1. Heavy chain and light chain variable sequences comprising anIle-Asp dipeptide at the N-terminus are identified in Table 4B.

TABLE 4B Heavy and Light Chain Amino Acid Sequence Designations, wherethe Sequence Includes an N-terminal Ile-Asp Dipeptide HC SEQ ID NO: LCSEQ ID NO: 15-ID 96 28-ID 110 16-ID 97 29-ID 111 17-ID 98 30-ID 11218-ID 99 35-ID 113 19-ID 100 31-ID 114 21-ID 101 32-ID 115 22-ID 10233-ID 116 20-ID 103 34-ID 117 23-ID 104 36-ID 118 24-ID 105 45-ID 11925-ID 106 46-ID 120 26-ID 107 37-ID 121 27-ID 108 38-ID 122 Hc consensusID 109 39-ID 123 (161-ID)  40-ID 124 41-ID 125 42-ID 126 43-ID 127 44-ID128 47-ID 129 48-ID 130 49-ID 131 50-ID 132 51-ID 133 52-ID 134 53-ID135 54-ID 136 55-ID 137 56-ID 138 57-ID 139 58-ID 140 59-ID 141 60-ID142 61ID 143 153-ID  157 154-ID  158 155-ID  159 156-ID  160 LCconsensus ID 144 (62-ID)

In another embodiment, an antibody featured in the disclosure is otherthan an antibody known in the art. For example, the antibody is not Ab67-11 (U.S. Provisional application No. 61/645,453) F16 (FI6, as usedherein, refers to any specifically disclosed FI6 sequence in U.S.Application Publication No. 2010/0080813, US Application Publication No.2011/0274702, International Publication No. WO2013/011347 or Corti etal., Science 333:850-856, 2011, published online Jul. 28, 2011; FIGS.12A to 12C of International Publication No. WO2013/170139 or U.S.Application Publication No. 2013/0302349), FI28 (U.S. ApplicationPublication No. 2010/0080813), and C179 (Okuno et al., J. Virol.67:2552-1558, 1993), F10 (Sui et al., Nat. Struct. Mol. Biol. 16:265,2009), CR9114 (Dreyfus et al., Science. 2012; 337(6100):1343-1348;published online Aug. 9, 2012), and CR6261 (Ekiert et al., Science324:246-251, 2009; published online Feb. 26, 2009). In one embodiment,an antibody featured in the disclosure is other than Ab 67-11 (U.S.Provisional application No. 61/645,453, filed on the same date as thepresent application).

Variants

In an embodiment, an antibody molecule, e.g., an antibody featured inthe disclosure has a variable heavy chain immunoglobulin domain that isat least 85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%, 97%, 98%, or 99%homologous, or at least 85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%,97%, 98%, or 99% identical, to a heavy chain disclosed herein, e.g.,from Table 3, Table 4A, or Table 4B, or FIG. 2, FIG. 13 or FIG. 17, ofInternational Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349, e.g. consensus sequence of SEQ ID NO: 161,and has a variable light chain immunoglobulin domain that is at least85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%, 97%, 98%, or 99%homologous, or at least 85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%,97%, 98%, or 99% identical, to a light chain disclosed herein, e.g.,from Table 3, Table 4A, or Table 4B, or FIG. 3, FIG. 14 or FIG. 17, ofInternational Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349, e.g., the consensus sequence of SEQ ID NO:62. The consensus sequences were determined through the analysis ofbiochemical and biophysical properties of several hundredcomputationally designed VH/VL combinations. The consensus sequencesrepresent the amino acid sequences in which each amino acid is the onethat occurs most frequently at that site when multiple sequencescomprising desirable biochemical and biophysical data are aligned.

An exemplary anti-HA binding antibody has one or more CDRs, e.g., allthree HC CDRs and/or all three LC CDRs of a particular antibodydisclosed herein, or CDRs that are, in sum, at least 85%, 87%, 88%, 89%,90%, 92%, 94%, 95%, 96%, 97%, 98%, or 99% homologous, or at least 85%,87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%, 97%, 98%, or 99% identical, tosuch an antibody. In one embodiment, the H1 and H2 hypervariable loopshave the same canonical structure as those of an antibody describedherein. In one embodiment, the L1 and L2 hypervariable loops have thesame canonical structure as those of an antibody described herein.

In one embodiment, the amino acid sequence of the HC and/or LC variabledomain sequence is at least 85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%,97%, 98%, or 99% homologous, or at least 85%, 87%, 88%, 89%, 90%, 92%,94%, 95%, 96%, 97%, 98%, or 99% identical, to the amino acid sequence ofthe HC and/or LC variable domain of an antibody described herein. Theamino acid sequence of the HC and/or LC variable domain sequence candiffer by at least one amino acid, but no more than ten, eight, six,five, four, three, or two amino acids from the corresponding sequence ofan antibody described herein. For example, the differences may beprimarily or entirely in the framework regions.

In certain embodiments, the amino acid differences are conservativeamino acid differences (e.g., conservative amino acid substitutions). A“conservative” amino acid substitution is one in which the amino acidresidue is replaced with an amino acid residue comprising a similar sidechain. Families of amino acid residues comprising similar side chainshave been defined in the art. These families include, e.g., amino acidswith basic side chains (e.g., lysine, arginine, histidine), acidic sidechains (e.g., aspartic acid, glutamic acid), uncharged polar side chains(e.g., glycine, asparagine, glutamine, serine, threonine, tyrosine,cysteine), nonpolar side chains (e.g., alanine, valine, leucine,isoleucine, proline, phenylalanine, methionine, tryptophan),beta-branched side chains (e.g., threonine, valine, isoleucine) andaromatic side chains (e.g., tyrosine, phenylalanine, tryptophan,histidine).

The amino acid sequences of the HC and LC variable domain sequences canbe encoded by a nucleic acid sequence that hybridizes under highstringency conditions to a nucleic acid sequence described herein or onethat encodes a variable domain or an amino acid sequence describedherein. In one embodiment, the amino acid sequences of one or moreframework regions (e.g., FR1, FR2, FR3, and/or FR4) of the HC and/or LCvariable domain are at least 85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%,96%, 97%, 98%, or 99% homologous, or at least 85%, 87%, 88%, 89%, 90%,92%, 94%, 95%, 96%, 97%, 98%, or 99% identical, to correspondingframework regions of the HC and LC variable domains of an antibodydescribed herein. In one embodiment, one or more heavy or light chainframework regions (e.g., HC FR1, FR2, and FR3) are at least 85%, 87%,88%, 89%, 90%, 92%, 94%, 95%, 96%, 97%, 98%, or 99% homologous, or atleast 85%, 87%, 88%, 89%, 90%, 92%, 94%, 95%, 96%, 97%, 98%, or 99%identical, to the sequence of corresponding framework regions from ahuman germline antibody.

Validation of Epitopes

In one embodiment, the antibodies featured in the disclosure are usefulfor validating a vaccine based on a particular epitope. For example, anepitope that is the target of an antibody featured in the disclosure canbe assessed by computation methods to identify a peptide frameworksuitable for supporting the epitope conformation, such as to stabilizean epitope that is transient or minimally accessible in nature.Computational abstraction of the epitope and framework properties allowsautomated screening of databases to identify candidate acceptor peptidescaffolds. The acceptor scaffold can have a particular tertiarystructure that includes, for example, one or more of a beta sheet, abeta sandwich, a loop, or an alpha or beta helix. The candidateepitope-scaffold antigens can be assayed in vitro, such as to identifybinding properties with an antibody featured in the disclosure, e.g.,binding affinity or structure analysis of the epitope-scaffold/antibodycomplex, or in vitro neutralization. The ability of the epitope-scaffoldto generate an immune response (e.g., to generate antibodies) can betested by administering the epitope-scaffold to an animal (e.g., in amammal, such as a rat, a mouse, a guinea pig, or a rabbit), and thentesting sera for the presence of anti-epitope-scaffold antibodies, e.g.,by ELISA assay. The ability of the epitope-scaffold to elicit protectionagainst infection by an influenza A Group 1 or Group 2 strain, or byboth types of influenza strains, or an influenza B strain, can beassessed in vivo, such as in an animal (e.g., in a mammal). Thus, anantibody featured in the disclosure can provide validation that theepitope is functionally important and that targeting the epitope willprovide protection from infection with a Group 1 or Group 2 influenzastrain, or both types of strains, or an influenza B strain.

Production of Antibody Molecules

The nucleic acids (e.g., the genes) encoding an antibody moleculegenerated by a method described herein can be sequenced, and all or partof the nucleic acids can be cloned into a vector that expresses all orpart of the nucleic acids. For example, the nucleic acids can include afragment of the gene encoding the antibody, such as a single chainantibody (scFv), a F(ab′)₂ fragment, a Fab fragment, or an Fd fragment.The disclosure also provides host cells comprising the nucleic acidsencoding an antibody or fragment thereof as described herein. The hostcells can be, for example, prokaryotic or eukaryotic cells, e.g.,mammalian cells, or yeast cells, e.g., Pichia (see, e.g., Powers et al.(2001) J. Immunol. Methods 251:123-35), Hanseula, or Saccharomyces.

Antibody molecules, particularly full length antibody molecules, e.g.,IgGs, can be produced in mammalian cells. Exemplary mammalian host cellsfor recombinant expression include Chinese Hamster Ovary (CHO) cells(including dhfr⁻ CHO cells, described in Urlaub and Chasin (1980) Proc.Natl. Acad. Sci. USA 77:4216-4220, used with a DHFR selectable marker,e.g., as described in Kaufman and Sharp (1982) Mol. Biol. 159:601-621),lymphocytic cell lines, e.g., NS0 myeloma cells and SP2 cells, COScells, K562, and a cell from a transgenic animal, e.g., a transgenicmammal. For example, the cell is a mammary epithelial cell. In additionto the nucleic acid sequence encoding the immunoglobulin domain, therecombinant expression vectors may carry additional nucleic acidsequences, such as sequences that regulate replication of the vector inhost cells (e.g., origins of replication) and selectable marker genes.The selectable marker gene facilitates selection of host cells intowhich the vector has been introduced (see e.g., U.S. Pat. Nos.4,399,216; 4,634,665; and 5,179,017). Exemplary selectable marker genesinclude the dihydrofolate reductase (DHFR) gene (for use in dhfr⁻ hostcells with methotrexate selection/amplification) and the neo gene (forG418 selection).

In an exemplary system for recombinant expression of an antibodymolecule (e.g., a full length antibody or an antigen-binding portionthereof), a recombinant expression vector encoding both the antibodyheavy chain and the antibody light chain is introduced into dhfr− CHOcells by calcium phosphate-mediated transfection. Within the recombinantexpression vector, the antibody heavy and light chain genes are eachoperatively linked to enhancer/promoter regulatory elements (e.g.,derived from SV40, CMV, adenovirus and the like, such as a CMVenhancer/AdMLP promoter regulatory element or an SV40 enhancer/AdMLPpromoter regulatory element) to drive high levels of transcription ofthe genes. The recombinant expression vector also carries a DHFR gene,which allows for selection of CHO cells that have been transfected withthe vector using methotrexate selection/amplification. The selectedtransformant host cells are cultured to allow for expression of theantibody heavy and light chains and intact antibody molecule isrecovered from the culture medium. Standard molecular biology techniquesare used to prepare the recombinant expression vector, to transfect thehost cells, to select for transformants, to culture the host cells, andto recover the antibody from the culture medium. For example, someantibodies can be isolated by affinity chromatography with a Protein Aor Protein G. For example, purified antibodies can be concentrated toabout 100 mg/mL to about 200 mg/mL using protein concentrationtechniques that are known in the art.

Antibody molecules can also be produced by a transgenic animal. Forexample, U.S. Pat. No. 5,849,992 describes a method for expressing anantibody molecule in the mammary gland of a transgenic mammal. Atransgene is constructed that includes a milk-specific promoter andnucleic acid sequences encoding the antibody molecule of interest, e.g.,an antibody described herein, and a signal sequence for secretion. Themilk produced by females of such transgenic mammals includes, secretedtherein, the antibody of interest, e.g., an antibody described herein.The antibody molecule can be purified from the milk, or for someapplications, used directly. Antibody molecules can also be expressed invivo, following administration of a vector containing nucleic acidsencoding the antibody heavy chain and the antibody light chain. Vectormediated gene-transfer is then used to engineer secretion of the anti-HAantibody into circulation. For example, an anti-HA antibody heavy chainand an anti-HA antibody light chain as described herein are cloned intoan adeno-associated virus (AAV)-based vector, and each of the anti-HAantibody heavy chain and the anti-HA antibody light chain are undercontrol of a promoter, such as a cytomegalovirus (CMV) promoter.Administration of the vector to a subject, such as to a patient, e.g., ahuman patient, such as by intramuscular injection, results in expressionof an anti-HA antibody, and secretion into the circulation.

Modifications of Binding Agents

Binding, agents, e.g., antibody molecules can be modified to havenumerous properties, e.g., to have altered, e.g., extended half-life, tobe associated with, e.g., covalently bound to detectable moieties, e.g.,labels, to be associated with, e.g., covalently bound to toxins, or tohave other properties, e.g., altered immune functions. Antibodymolecules may include modifications, e.g., modifications that alter Fcfunction, e.g., to decrease or remove interaction with an Fc receptor orwith C1q, or both. In one example, the human IgG1 constant region can bemutated at one or more residues.

For some antibody molecules that include an Fc domain, the antibodyproduction system may be designed to synthesize antibody molecules inwhich the Fc region is glycosylated. The Fc domain can be produced in amammalian expression system that appropriately glycosylates the residuecorresponding to asparagine 297. The Fc domain can also include othereukaryotic post-translational modifications. Other suitable Fc domainmodifications include those described in WO2004/029207. For example, theFc domain can be an XmAb® Fc (Xencor, Monrovia, Calif.). The Fc domain,or a fragment thereof, can have a substitution in an Fcγ Receptor (FcγR)binding region, such as the domains and fragments described inWO05/063815. In some embodiments, the Fc domain, or a fragment thereof,has a substitution in a neonatal Fc Receptor (FcRn) binding region, suchas the domains and fragments described in WO05047327. In otherembodiments, the Fc domain is a single chain, or fragment thereof, ormodified version thereof, such as those described in WO2008143954. Othersuitable Fc modifications are known and described in the art.

Antibody molecules can be modified, e.g., with a moiety that improvesits stabilization and/or retention in circulation, e.g., in blood,serum, lymph, bronchoalveolar lavage, or other tissues, e.g., by atleast 1.5, 2, 5, 10, or 50 fold. For example, an antibody moleculegenerated by a method described herein can be associated with a polymer,e.g., a substantially non-antigenic polymer, such as a polyalkyleneoxide or a polyethylene oxide. Suitable polymers will vary substantiallyby weight. Polymers comprising molecular number average weights rangingfrom about 200 to about 35,000 daltons (or about 1,000 to about 15,000,and 2,000 to about 12,500) can be used.

For example, an antibody molecule generated by a method described hereincan be conjugated to a water soluble polymer, e.g., a hydrophilicpolyvinyl polymer, e.g. polyvinylalcohol or polyvinylpyrrolidone. Anon-limiting list of such polymers include polyalkylene oxidehomopolymers such as polyethylene glycol (PEG) or polypropylene glycols,polyoxyethylenated polyols, copolymers thereof and block copolymersthereof, provided that the water solubility of the block copolymers ismaintained. Additional useful polymers include polyoxyalkylenes such aspolyoxyethylene, polyoxypropylene, and block copolymers ofpolyoxyethylene and polyoxypropylene (Pluronics); polymethacrylates;carbomers; branched or unbranched polysaccharides that comprise thesaccharide monomers D-mannose, D- and L-galactose, fucose, fructose,D-xylose, L-arabinose, D-glucuronic acid, sialic acid, D-galacturonicacid, D-mannuronic acid (e.g. polymannuronic acid, or alginic acid),D-glucosamine, D-galactosamine, D-glucose and neuraminic acid includinghomopolysaccharides and heteropolysaccharides such as lactose,amylopectin, starch, hydroxyethyl starch, amylose, dextrane sulfate,dextran, dextrins, glycogen, or the polysaccharide subunit of acidmucopolysaccharides, e.g. hyaluronic acid; polymers of sugar alcoholssuch as polysorbitol and polymannitol; heparin or heparan.

Binding agents, e.g., antibody molecules, as disclosed herein, can byconjugated to another entity or moiety (e.g., to a cytotoxic orcytostatic moiety, a label or detectable moiety, or a therapeuticmoiety). Exemplary moieties include: a cytotoxic or cytostatic agent,e.g., a therapeutic agent, a drug, a compound emitting radiation,molecules of plant, fungal, or bacterial origin, or a biological protein(e.g., a protein toxin) or particle (e.g., a recombinant viral particle,e.g., via a viral coat protein), a detectable agent; a pharmaceuticalagent, and/or a protein or peptide that can mediate association of theantibody or antibody portion with another molecule (such as astreptavidin core region or a polyhistidine tag). A binding agent, e.g.,an antibody molecule, as disclosed herein, can be functionally linked byany suitable method (e.g., chemical coupling, genetic fusion, covalentbinding, noncovalent association or otherwise) to one or more othermolecular entities.

Binding agents, e.g., antibody molecules, disclosed herein can beconjugated with a detectable moiety, e.g., a label or imaging agent.Such moieties can include enzymes (e.g., horseradish peroxidase,beta-galactosidase, luciferase, alkaline phosphatase,acetylcholinesterase, glucose oxidase and the like), radiolabels (e.g.,³H, ¹⁴C, ¹⁵N, ³⁵S, ⁹⁰Y, ⁹⁹Tc, ¹¹¹In, ¹²⁵I, ¹³¹I and the like), haptens,fluorescent labels (e.g., FITC, rhodamine, lanthanide phosphors,fluorescein, fluorescein isothiocyanate, rhodamine,5-dimethylamine-1-napthalenesulfonyl chloride, phycoerythrin and thelike), phosphorescent molecules, chemiluminescent molecules,chromophores, luminescent molecules, photoaffinity molecules, coloredparticles or affinity ligands, such as biotin, predetermined polypeptideepitopes recognized by a secondary reporter (e.g., leucine zipper pairsequences, or binding sites for secondary antibodies, metal bindingdomains, epitope tags). In some embodiments, a moiety, e.g., adetectable moiety, e.g., a label, is attached by spacer arms of variouslengths to reduce potential steric hindrance.

In some embodiments, a binding agent, e.g., antibody molecule, disclosedherein, is derivatized with a detectable enzyme and is detected byadding additional reagents that the enzyme uses to produce a detectablereaction product. For example, when the detectable agent horseradishperoxidase is present, the addition of hydrogen peroxide anddiaminobenzidine leads to a colored reaction product, which isdetectable. A binding agent, e.g., antibody molecule, disclosed herein,ay also be derivatized with a prosthetic group (e.g.,streptavidin/biotin and avidin/biotin). For example, an antibody may bederivatized with biotin, and detected through indirect measurement ofavidin or streptavidin binding.

In some embodiments, the moiety comprises paramagnetic ions andNMR-detectable substances, among others. For example, in someembodiments, a paramagnetic ion is one or more of chromium (III),manganese (II), iron (III), iron (II), cobalt (II), nickel (II), copper(II), neodymium (III), samarium (III), ytterbium (III), gadolinium(III), vanadium (II), terbium (III), dysprosium (III), holmium (III),erbium (III), lanthanum (III), gold (III), lead (II), and/or bismuth(III). Binding agents, e.g., antibody molecules, as disclosed herein,can be modified to be associated with, e.g., conjugated to, atherapeutic agent, e.g., an agent comprising anti-viral activity,anti-inflammatory activity, or cytotoxic activity, etc. In someembodiments, therapeutic agents can treat symptoms or causes ofinfluenza infection (e.g., for example, anti-viral, pain-relief,antiinflammatory, immunomodulatory, sleep-inducing activities, etc).

Treatment Methods and Administration

The binding agents, e.g., antibody molecules, featured in thedisclosure, can be used to treat a subject, e.g., a subject, e.g., ahuman subject, infected with, or at risk for becoming infected with, aninfluenza virus.

Any human is candidate to receive an antibody molecule featured in thedisclosure for treatment or prevention of an infection by an influenzavirus. Humans at high risk of infection, such as immunocompromisedindividuals, and humans who are at high risk of exposure to influenzavirus are particularly suited to receive treatment with the antibodymolecule. Immunocompromised individuals include the elderly (65 yearsand older) and children (e.g., 6 months to 18 years old), and peoplewith chronic medical conditions. People at high risk of exposure includeheath care workers, teachers and emergency responders (e.g.,firefighters, policemen).

The antibody molecules described herein can also be used to prevent orreduce (e.g., minimize) secondary infection (e.g., secondary bacterialinfection) or a risk of comprising secondary infection associated withinfluenza, or any effects (e.g., symptoms or complications) thereof on asubject. Opportunistic secondary bacterial infections (e.g., secondarybacterial pneumonia, e.g., primarily with Streptococcus pneumonia)contribute significantly to the overall morbidity and mortalityassociated with seasonal and pandemic influenza infections. The antibodymolecules described herein can be used to prevent or reduce (e.g.,minimize) the complications from secondary, opportunistic infections(e.g., bacterial infections) in a subject.

An antibody molecule can be administered to a subject, e.g., a humansubject, by a variety of methods. For many applications, the route ofadministration is one of: intravenous injection or infusion,subcutaneous injection, or intramuscular injection. An antibody moleculecan be administered as a fixed dose, or in a mg/kg dose. The antibodymolecule can be administered intravenously (IV) or subcutaneously (SC).For example, the antibody molecule can be administered at a fixed unitdose of between about 50-600 mg IV, e.g., every 4 weeks, or betweenabout 50-100 mg SC (e.g., 75 mg), e.g., at least once a week (e.g.,twice a week). In one embodiment, the antibody molecule is administeredIV at a fixed unit dose of 50 mg, 60 mg, 80 mg, 100 mg, 120 mg, 130 mg,140 mg, 150 mg, 160 mg, 180 mg, 200 mg, 300 mg, 400 mg, 500 mg, or 600mg or more. Administration of the IV dose can be once or twice or threetimes or more per week, or once every two, three, four, or five weeks,or less frequently.

An anti-HA antibody molecule featured in the disclosure can also beadministered intravenously, such as a fixed unit dose between 500 mg and3000 mg, e.g., between 1000 mg and 3000 mg, between 1500 mg and 3000 mg,between 2000 mg and 3000 mg, between 1800 mg and 2500 mg, between 2500mg and 3000 mg, between 500 mg and 2500 mg, between 500 mg and 2000 mg,between 500 mg and 1500 mg, between 500 mg and 1000 mg, between 1000 mgand 2500 mg, between 1500 mg and 2000 mg, or between 2000 mg and 2500mg, e.g., 1500 mg, 1600 mg, 1700 mg, 1800 mg, 1900 mg, 2000 mg, 2100 mg,2200 mg, 2300 mg, 2400 mg, or 2500 mg. In an embodiment, the antibodymolecule is administered intravenously over a period of 1-3 hours, e.g.,1-2 hours or 2 to 3 hours, e.g., 2 hours. In an embodiment, the antibodymolecule is administered as a single dose. In one embodiment, theantibody molecule is administered SC at a fixed unit dose of 50 mg, 60mg, 70 mg, 75 mg, 80 mg, 100 mg, or 120 mg or more. Administration ofthe SC dose can be once or twice or three times or more per week, oronce every two, three, four, or five weeks, or less frequently. Ananti-HA antibody molecule featured in the disclosure can also beadministered by inhalation, such as by intranasal or by oral inhalation,such as at a fixed unit dose of 50 mg, 60 mg, 80 mg, 100 mg, 120 mg, 130mg, 140 mg, 150 mg, 160 mg, 180 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600mg, 700 mg, 800 mg, 900 mg, 1000 mg, 1100 mg, 1200 mg, 1300 mg, 1400 mg,1500 mg, 1600 mg, 1700 mg, 1800 mg, 1900 mg, 2000 mg, 2100 mg, 2200 mg,2300 mg, 2400 mg, 2500 mg, or more.

In an embodiment, the antibody molecule is administered in an amountthat does not cause an ADE in the subject, e.g., as determined by amethod described herein. In an embodiment, the antibody molecule isadministered in an amount that does not cause viral resistance, e.g., asdetermined by a method described herein. In one embodiment, an anti-HAantibody is administered to a subject via vector-mediated gene transfer,such as through the delivery of a vector encoding the heavy chain andthe light chain of an anti-HA antibody, and the antibody is expressedfrom the heavy chain and light chain genes in the body. For example,nucleic acids encoding a heavy chain and a light chain can be cloned ina AAV vector, such as a self-complementary AAV vector, the scAAV vectoradministered to a human by injection, such as by IM injection, and theantibody is expressed and secreted into the circulation of the human.

An antibody molecule can also be administered in a bolus at a dose ofbetween about 1 and 50 mg/kg, e.g., between about 1 and 10 mg/kg,between about 1 and 25 mg/kg or about 25 and 50 mg/kg, e.g., about 50mg/kg, 25 mg/kg, 10 mg/kg, 6.0 mg/kg, 5.0 mg/kg, 4.0 mg/kg, 3.0 mg/kg,2.0 mg/kg, 1.0 mg/kg, or less. Modified dose ranges include a dose thatis less than about 3000 mg/subject, about 1500 mg/subject, about 1000mg/subject, about 600 mg/subject, about 500 mg/subject, about 400mg/subject, about 300 mg/subject, about 250 mg/subject, about 200mg/subject, or about 150 mg/subject, typically for administration everyfourth week or once a month. The antibody molecule can be administered,for example, every three to five weeks, e.g., every fourth week, ormonthly.

Dosing can be adjusted according to a patient's rate of clearance of aprior administration of the antibody. For example, a patient may not beadministered a second or follow-on dose before the level of antibodiesin the patient's system has dropped below a pre-determined level. In oneembodiment, a sample from a patient (e.g., plasma, serum, blood, urine,or cerebrospinal fluid (CSF)) is assayed for the presence of antibodies,and if the level of antibodies is above a pre-determined level, thepatient will not be administered a second or follow-on dose. If thelevel of antibodies in the patient's system is below a pre-determinedlevel, then the patient is administered a second or follow-on dose. Apatient whose antibody levels are determined to be too high (above thepre-determined level) can be tested again after one or two or threedays, or a week, and if the level of antibody in the patient samples hasdropped below the pre-determined level, the patient may be administereda second or follow-on dose of antibody.

In certain embodiments, the antibody may be prepared with a carrier thatwill protect the drug against rapid release, such as a controlledrelease formulation, including implants, and microencapsulated deliverysystems. Biodegradable, biocompatible polymers can be used, such asethylene vinyl acetate, polyanhydrides, polyglycolic acid, collagen,polyorthoesters, and polylactic acid. Many methods for the preparationof such formulations are patented or generally known. See, e.g.,Controlled Drug Delivery (Drugs and the Pharmaceutical Sciences), SecondEdition, J. Robinson and V. H. L. Lee, eds., Marcel Dekker, Inc., NewYork, 1987.

Pharmaceutical compositions can be administered with a medical device.For example, pharmaceutical compositions can be administered with aneedleless hypodermic injection device, such as the devices disclosed inU.S. Pat. Nos. 5,399,163; 5,383,851; 5,312,335; 5,064,413; 4,941,880;4,790,824; or 4,596,556. Examples of well-known implants and modules arediscussed in, e.g., U.S. Pat. No. 4,487,603, which discloses animplantable micro-infusion pump for dispensing medication at acontrolled rate; U.S. Pat. No. 4,486,194, which discloses a therapeuticdevice for administering medicaments through the skin; U.S. Pat. No.4,447,233, which discloses a medication infusion pump for deliveringmedication at a precise infusion rate; U.S. Pat. No. 4,447,224, whichdiscloses a variable flow implantable infusion apparatus for continuousdrug delivery; U.S. Pat. No. 4,439,196, which discloses an osmotic drugdelivery system comprising multi-chamber compartments; and U.S. Pat. No.4,475,196, which discloses an osmotic drug delivery system. Of course,many other such implants, delivery systems, and modules are also known.In some embodiments, the binding agent, e.g., an antibody molecule, isadministered buccally, orally, or by nasal delivery, e.g., as a liquid,spray, or aerosol, e.g., by topical application, e.g., by a liquid ordrops, or by inhalation.

An antibody molecule described herein can be administered with one ormore additional therapeutic agents, e.g., a second drug, for treatmentof a viral infection, or a symptom of the infection. The antibodymolecule and the one or more second or additional agents can beformulated together, in the same formulation, or they can be in separateformulations, and administered to a patient simultaneously orsequentially, in either order.

Dosage regimens are adjusted to provide the desired response, such as atherapeutic response or a combinatorial therapeutic effect. Generally,any combination of doses (either separate or co-formulated) of anantibody molecule and a second or additional agent can be used in orderto provide a subject with both agents in bioavailable quantities. Dosageunit form or “fixed dose” as used herein refers to physically discreteunits suited as unitary dosages for the subjects to be treated; eachunit contains a predetermined quantity of active compound calculated toproduce the desired therapeutic effect in association with the requiredpharmaceutical carrier and optionally in association with another agent.

A pharmaceutical composition may include a “therapeutically effectiveamount” of an agent described herein. In some embodiments, where theantibody molecule is administered in combination with a second oradditional agent, such effective amounts can be determined based on thecombinatorial effect of the administered first and second or additionalagent. A therapeutically effective amount of an agent may also varyaccording to factors such as the disease state, age, sex, and weight ofthe individual, and the ability of the compound to elicit a desiredresponse in the individual, such as amelioration of at least oneinfection parameter, or amelioration of at least one symptom of theinfection, such as chills, fever, sore throat, muscle pain, headache,coughing, weakness, fatigue and general discomfort. A therapeuticallyeffective amount is also one in which any toxic or detrimental effectsof the composition are outweighed by the therapeutically beneficialeffects.

In an embodiment, administration of a binding agent, e.g., antibodymolecule, provided, e.g., as a pharmaceutical preparation, is by one ofthe following routes: oral, intravenous, intramuscular, intra-arterial,subcutaneous, intraventricular, transdermal, interdermal, rectal,intravaginal, intraperitoneal, topical (as by liquids, powders,ointments, creams, sprays, or drops), mucosal, nasal, buccal, enteral,sublingual; intratracheal instillation, bronchial instillation, and/orinhalation; and/or as an oral spray, nasal spray, and/or aerosol. In anembodiment, the method described herein further comprises determiningthe presence or absence of an anti-drug antibody (ADA) in the subject.In an embodiment, the subject is selected for administration of anantibody molecule described herein on the basis of the absence of an ADAin the subject. ADA can be detected, e.g., by ELISA, in a sample fromthe subject.

Combination Treatments and Exemplary Second or Additional Agents

Binding agents, e.g., antibody molecules, provided e.g., aspharmaceutical compositions, can be administered either alone or incombination with one or more other therapy, e.g., the administration ofa second or additional therapeutic agent.

In some embodiments, the combination can result in a lower dose of theantibody molecule or of the other therapy being needed, which, in someembodiments, can reduce side effects. In some embodiments, thecombination can result in enhanced delivery or efficacy of one or bothagents. The agents or therapies can be administered at the same time(e.g., as a single formulation that is administered to a patient or astwo separate formulations administered concurrently) or sequentially inany order. Such second or additional agents include vaccines, anti-viralagents, and/or additional antibodies. In typical embodiments the secondor additional agent is not co-formulated with the binding agent, e.g.,antibody molecule, though in others it is. In some embodiments, thebinding agent, e.g., antibody molecule, and the second or additionalagent are administered such that one or more of the following isachieved: therapeutic levels, or therapeutic effects, of one overlap theother; detectable levels of both are present at the same time; or thetherapeutic effect is greater than what would be seen in the absence ofeither the binding agent, e.g., antibody molecule, or the second oradditional agent. In some embodiments, each agent will be administeredat a dose and on a time schedule determined for that agent.

The second or additional agent can be, for example, for treatment orprevention of influenza. For example, the binding agents, e.g., antibodymolecules, e.g., therapeutic antibodies, provided herein can beadministered in combination with a vaccine, e.g., a vaccine describedherein or a mixture (a.k.a. a cocktail) of influenza peptides tostimulate the patient's immune system to prevent infection withparticular strains of influenza A. In other examples, the second oradditional agent is an anti-viral agent (e.g., an anti-NA or anti-M2agent), a pain reliever, an anti-inflammatory, an antibiotic, asteroidal agent, a second therapeutic antibody molecule (e.g., ananti-HA antibody), an adjuvant, a protease or glycosidase (e.g.,sialidase), etc.

Exemplary anti-viral agents include, e.g., vaccines, neuraminidaseinhibitors or nucleoside analogs. Exemplary anti-viral agents caninclude, e.g., zidovudine, gangcyclovir, vidarabine, idoxuridine,trifluridine, foscarnet, acyclovir, ribavirin, amantadine, remantidine,saquinavir, indinavir, ritonavir, alpha-interferons and otherinterferons, a neuraminidase inhibitor (e.g., zanamivir (Relenza®),oseltamivir (Tamiflu®), laninamivir, peramivir), rimantadine. Exemplarysecond antibody molecules include, for exampleAb 67-11 (U.S. Provisionalapplication No. 61/645,453, FI6 (U.S. Application Publication No.2010/0080813), FI28 (U.S. Application Publication No. 2010/0080813),C179 (Okuno et al., J. Virol. 67:2552-8, 1993), F10 (Sui et al., Nat.Struct. Mol. Biol. 16:265, 2009), CR9114 (Dreyfus et al., Science337:1343, 2012), or CR6261 (Ekiert et al., Science 324:246, 2009). Thus,Ab 044 can be used in combination of any of those antibodies. In otherembodiments, two or more binding agents, e.g., antibody moleculesdisclosed herein, can be administered in combination, e.g., Ab 044 canbe administered in combination with Ab 032. In the case of combinations,two agents can be administered as part of the same dosage unit oradministered separately. Other exemplary agents useful for treating thesymptoms associated with influenza infection are acetaminophen,ibuprofen, aspirin, and naproxen.

In one embodiment, the antibody molecule and the second or additionalagent are provided as a co-formulation, and the co-formulation isadministered to the subject. It is further possible, e.g., at least 24hours before or after administering the co-formulation, to administerseparately one dose of the antibody formulation and then one dose of aformulation containing a second or additional agent. In anotherimplementation, the antibody molecule and the second or additional agentare provided as separate formulations, and the step of administeringincludes sequentially administering the antibody molecule and the secondor additional agent. The sequential administrations can be provided onthe same day (e.g., within one hour of one another or at least 3, 6, or12 hours apart) or on different days.

In some embodiments, the antibody molecule and the second or additionalagent are each administered as a plurality of doses separated in time.The antibody molecule and the second or additional agent are generallyeach administered according to a regimen. The regimen for one or bothmay have a regular periodicity. The regimen for the antibody moleculecan have a different periodicity from the regimen for the second oradditional agent, e.g., one can be administered more frequently than theother. In one implementation, one of the antibody molecule and thesecond or additional agent is administered once weekly and the otheronce monthly. In another implementation, one of the antibody moleculeand the second or additional agent is administered continuously, e.g.,over a period of more than 30 minutes but less than 1, 2, 4, or 12hours, and the other is administered as a bolus. In some embodiments,sequential administrations are administered. The time betweenadministration of the one agent and another agent can be minutes, hours,days, or weeks. The use of an antibody molecule described herein canalso be used to reduce the dosage of another therapy, e.g., to reducethe side-effects associated with another agent that is beingadministered. Accordingly, a combination can include administering asecond or additional agent at a dosage at least 10, 20, 30, or 50% lowerthan would be used in the absence of the antibody molecule. The antibodymolecule and the second or additional agent can be administered by anyappropriate method, e.g., subcutaneously, intramuscularly, orintravenously.

In some embodiments, each of the antibody molecule and the second oradditional agent is administered at the same dose as each is prescribedfor monotherapy. In other embodiments, the antibody molecule isadministered at a dosage that is equal to or less than an amountrequired for efficacy if administered alone. Likewise, the second oradditional agent can be administered at a dosage that is equal to orless than an amount required for efficacy if administered alone. In somecases, the formulations described herein, e.g., formulations containingan antibody molecule featured in the disclosure, include one or moresecond or additional agents, or are administered in combination with aformulation containing one or more second or additional agents. In anembodiment a binding agent, e.g., antibody molecule, provided, e.g., asa pharmaceutical preparation, is administered by inhalation or aerosoldelivery of a plurality of particles, e.g., particles comprising a meanparticle size of 4, 5, 6, 7, 8, 9, 10, 11, 12, or 13 microns.

Pharmaceutical Compositions

The binding agents, e.g., antibody molecules, featured in the disclosurecan be formulated as pharmaceutical compositions, such as for thetreatment or prevention of influenza.

Typically, a pharmaceutical composition includes a pharmaceuticallyacceptable carrier. As used herein, “pharmaceutically acceptablecarrier” includes any and all solvents, dispersion media, coatings,antibacterial and antifungal agents, isotonic and absorption delayingagents, and the like that are physiologically compatible.

A “pharmaceutically acceptable salt” refers to a salt that retains thedesired biological activity of the parent compound and does not impartany undesired toxicological effects (see e.g., Berge, S. M., et al.(1977) J. Pharm. Sci. 66:1-19). Examples of such salts include acidaddition salts and base addition salts. Acid addition salts includethose derived from nontoxic inorganic acids, such as hydrochloric,nitric, phosphoric, sulfuric, hydrobromic, hydroiodic, and the like, aswell as from nontoxic organic acids such as aliphatic mono- anddicarboxylic acids, phenyl-substituted alkanoic acids, hydroxy alkanoicacids, aromatic acids, aliphatic and aromatic sulfonic acids and thelike. Base addition salts include those derived from alkaline earthmetals, such as sodium, potassium, magnesium, calcium and the like, aswell as from nontoxic organic amines, such asN,N′-dibenzylethylenediamine, N-methylglucamine, chloroprocaine,choline, diethanolamine, ethylenediamine, procaine and the like.

The compositions comprising antibody molecules can be formulatedaccording to methods known in the art. Pharmaceutical formulation is awell-established art, and is further described in Gennaro (ed.),Remington: The Science and Practice of Pharmacy, 20^(th) ed.,Lippincott, Williams & Wilkins (2000) (ISBN: 0683306472); Ansel et al.,Pharmaceutical Dosage Forms and Drug Delivery Systems, 7^(th) Ed.,Lippincott Williams & Wilkins Publishers (1999) (ISBN: 0683305727); andKibbe (ed.), Handbook of Pharmaceutical Excipients AmericanPharmaceutical Association, 3^(rd) ed. (2000) (ISBN: 091733096X).

Pharmaceutical compositions may be in a variety of forms. These include,for example, liquid, semi-solid and solid dosage forms, such as liquidsolutions (e.g., injectable and infusible solutions), dispersions orsuspensions, tablets, pills, powders, liposomes and suppositories. Theform can depend on the intended mode of administration and therapeuticapplication. Typically, compositions for the agents described herein arein the form of injectable or infusible solutions. Such compositions canbe administered by a parenteral mode (e.g., intravenous, subcutaneous,intraperitoneal, or intramuscular injection). The phrases “parenteraladministration” and “administered parenterally” as used herein meanmodes of administration other than enteral and topical administration,usually by injection, and include, without limitation, intravenous,intramuscular (IM), intraarterial, intrathecal, intracapsular,intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal,subcutaneous, subcuticular, intraarticular, subcapsular, subarachnoid,intraspinal, epidural and by intrasternal injection or by infusion.

Pharmaceutical compositions may be provided in a sterile injectable form(e.g., a form that is suitable for subcutaneous injection or intravenousinfusion). In some embodiments, pharmaceutical compositions are providedin a liquid dosage form that is suitable for injection or topicalapplication. In some embodiments, pharmaceutical compositions areprovided as in dry form, e.g., as powders (e.g. lyophilized and/orsterilized preparations). The Pharmaceutical composition can be providedunder conditions that enhance stability, e.g., under nitrogen or undervacuum. Dry material can be reconstituted with an aqueous diluent (e.g.,water, buffer, salt solution, etc.) prior to injection.

In one embodiment, the pharmaceutical composition containing an anti-HAantibody is administered intranasally. In another embodiment, thepharmaceutical composition containing an anti-HA antibody isadministered by inhalation, such as by oral or by nasal inhalation. Insome embodiments, the pharmaceutical composition is suitable for buccal,oral or nasal delivery, e.g., as a liquid, spray, or aerosol, e.g., bytopical application, e.g., by a liquid or drops, or by inhalation). Insome embodiments, a pharmaceutical preparation comprises a plurality ofparticles, suitable, e.g., for inhaled or aerosol delivery. In someembodiments, the mean particle size of 4, 5, 6, 7, 8, 9, 10, 11, 12, or13 microns. In some embodiments, a pharmaceutical preparation isformulated as a dry powder, suitable, e.g., for inhaled or aerosoldelivery. In some embodiments, a pharmaceutical preparation isformulated as a wet powder, through inclusion of a wetting agent, e.g.,water, saline, or other liquid of physiological pH. In some embodiments,a pharmaceutical preparation is provided as drops, suitable, e.g., fordelivery to the nasal or buccal cavity. In some embodiments, thepharmaceutical composition is disposed in a delivery device, e.g., asyringe, a dropper or dropper bottle, an inhaler, or a metered dosedevice, e.g., an inhaler.

In one embodiment, a pharmaceutical composition contains a vector, suchas an adenovirus-associated virus (AAV)-based vector, that encodes aheavy chain of an anti-HA antibody molecule, and a light chain of ananti-HA antibody molecule featured in the disclosure. The compositioncontaining the vector can be administered to a subject, such as apatient, such as by injection, e.g., IM injection. Genes encoding theanti-HA antibody under control of, for example, cytomegalovirus (CMV)promoters, are expressed in the body, and the recombinant anti-HAantibody molecule is introduced into the circulation. See, e.g., Balazset al., Nature 30:481:81-84, 2011.

Pharmaceutical compositions typically should be sterile and stable underthe conditions of manufacture and storage. A pharmaceutical compositioncan also be tested to insure it meets regulatory and industry standardsfor administration. The composition can be formulated as a solution,microemulsion, dispersion, liposome, or other ordered structure suitableto high drug concentration. Sterile injectable solutions can be preparedby incorporating an agent described herein in the required amount in anappropriate solvent with one or a combination of ingredients enumeratedabove, as required, followed by filtered sterilization. Generally,dispersions are prepared by incorporating an agent described herein intoa sterile vehicle that contains a basic dispersion medium and therequired other ingredients from those enumerated above. In the case ofsterile powders for the preparation of sterile injectable solutions,typical methods of preparation are vacuum drying and freeze-drying thatyields a powder of an agent described herein plus any additional desiredingredient from a previously sterile-filtered solution thereof. Theproper fluidity of a solution can be maintained, for example, by the useof a coating such as lecithin, by the maintenance of the requiredparticle size in the case of dispersion and by the use of surfactants.Prolonged absorption of injectable compositions can be brought about byincluding in the composition an agent that delays absorption, forexample, monostearate salts and gelatin.

A pharmaceutical composition may be provided, prepared, packaged, and/orsold in bulk, as a single unit dose, and/or as a plurality of singleunit doses. Typically a bulk preparation will contain at least 2, 5, 10,20, 50, or 100 unit doses. A unit dose is typically the amountintroduced into the patient in a single administration. In someembodiments, only a portion of a unit dose is introduced. In someembodiments, a small multiple, e.g., as much as 1.5, 2, 3, 5, or 10times a unit dose is administered. The amount of the active ingredientis generally equal to a dose which would be administered to a subjectand/or a convenient fraction of such a dose such as, for example,one-half or one-third of such a dose.

Immunogens and Vaccines

Antibodies of the invention have elucidated epitopes that are useful forinducing immunity to, and in some embodiments, provide protection from,one or more, e.g., at least two, influenza strains. These epitopes arereferred to herein as “broad range immunogens.” As used herein, the term“broad range vaccine” refers to a preparation comprising a broad rangeimmunogen, or a nucleic acid encoding a broad range immunogen, that caninduce formation of antibodies or immunity against the broad rangeimmunogen or an organism, e.g., an influenza virus. Additionalimmunogens and vaccines, and uses thereof, are described inInternational Publication No. WO2013/170139 or U.S. ApplicationPublication No. 2013/0302349, the contents of which are herebyincorporated by reference in their entirety.

EPitope

HAs exist in nature as homotrimers of proteolytically processed maturesubunits. Each subunit of the trimer is synthesized as a precursor. Aprecursor molecule is proteolytically processed into two disulfidebonded polypeptide chains to form a mature HA polypeptide. The mature HApolypeptide includes two domains: (1) a core HA-1 domain that extendsfrom the base of the molecule through the fibrous stem to the membranedistal head region that contains the glycan receptor binding domain,returning to fibrous region ending in the cleavage site, and (2) HA-2domain that includes the stem region and the transmembrane domain of HA.HA-1 includes a glycan binding site. The glycan binding site may beresponsible for mediating binding of HA to the HA-receptor. The HA-2domain acts to present the HA-1 domain. The HA trimer can be stabilizedby polar and non-polar interactions between the three long HAalpha-helices of the stem of HA monomers.

HA sequences from all influenza subtypes share a set of amino acids inthe interface of the HA-1 and HA-2 domains that are well conserved. TheHA-1/HA-2 interface membrane proximal epitope region (MPER) thatincludes the canonical a-helix and residues in its vicinity are alsoconserved across a broad spectrum of subtypes. (Ekiert et al., Science.,324(5924):246, 2009; Sui et al., Nat Struct Mol Biol. 16(3):265, 2009).

Ab 044 has high affinity for HA's from Group 1 and Group 2. It binds aconformational epitope that is broadly conserved across a plurality ofinfluenza strains. Numerous amino acid residues distributed along thelinear sequences of HA from different strains/subtypes contribute the Ab044 conformational epitope. The interaction of Ab 044 with H3 wasanalyzed by docking studies and residues bound by (or not bound by) Ab044 were identified. The Fv of Ab 044 was docked against HA of group Iand II strains using ZDOCK. The structure of the HA antigen was modeledusing the SWISS MODEL homology modeling server keeping the solvedcrystal structure of H1N1 as the template. ZDOCK uses shapecomplementarity along with desolvation and electrostatic energy terms(‘ZRANK’) to rank docked poses. To ensure the docked poses do notdeviate significantly from the native complex, mapped epitope andparatope residues by alanine scanning are forced to be included in thebinding interface.

For comparison studies, amino acids that bind (or do not bind) F16 weretaken from published US patent application US 2011/0274702 A1,Neutralizing Anti-Influenza A Virus Antibodies and Uses Thereof, filedJul. 18, 2011.

ZDOCK is a Fast Fourier Transform based protein docking program. It wasdeveloped by Zhiping Weng at the University of Massachusetts MedicalSchool. In ZDOCK, two PDB files are input and the output is thepredicted structure of their complex. The program searches all possiblebinding modes in the translational and rotational space between the twoproteins and evaluates each by an energy scoring function. The protein'sstructure is converted to a digital signal and a Fast Fourier Transformtechnique used to reduce computational time. ZDOCK is discussed inPierce B G, Hourai Y, Weng Z. (2011) Accelerating Protein Docking inZDOCK Using an Advanced 3D Convolution Library. PLoS One 6(9): e24657,Pierce B, Tong W, Weng Z. (2005) M-ZDOCK: A Grid-based Approach forC_(n) Symmetric Multimer Docking. Bioinformatics 21(8): 1472-1476;Mintseris J, Pierce B, Wiehe K, Anderson R, Chen R, Weng Z. (2007)Integrating Statistical Pair Potentials into Protein Complex Prediction.Proteins 69(3): 511-520; and Chen R, Li L, Weng Z. (2003) ZDOCK: AnInitial-stage Protein Docking Algorithm. Proteins 52(1): 80-7.

SWISS-MODEL is a fully automated protein structure homology-modelingserver. It is accessible via the ExPASy web server, or from the programDeepView (Swiss Pdb-Viewer). Swiss-Model is discussed in Arnold K.,Bordoli L., Kopp J., and Schwede T. (2006). The SWISS-MODEL Workspace: Aweb-based environment for protein structure homology modelling.Bioinformatics, 22, 195-201; Kiefer F, Arnold K, Kiinzli M, Bordoli L,Schwede T (2009). The SWISS-MODEL Repository and associated resources.Nucleic Acids Research. 37, D387-D392; and Peitsch, M. C. (1995) Proteinmodeling by E-mail Bio/Technology 13: 658-660.

H3 residues that bind Ab 044 and H3 residues that bind F16 are discussedbelow.

H3 HA1

The amino acid sequence of H3 HA1 is provided below, as SEQ ID NO: 173.Residues N38, 1278, and D291 shown in dashed boxes, are bound by Ab 044but not by FI6; Residues Q327, T328, and R329 shown in dotted boxes, arebound by FI6 but not by Ab 044; residues T318, R321, and V323 shown insolid boxes, are bound by both Ab 044 and FI6.

(SEQ ID NO: 173)

GIDCTLIDAL LGDPHCDVFQ NETWDLFVER SKAFSNCYPY DVPDYASLRS LVASSGTLEFITEGFTWTGV TQNGGSNACK RGPGSGFFSR LNWLTKSGST YPVLNVTMPN NDNFDKLYIWGIHHPSTNQE QTSLYVQASG RVTVSTRRSQ QTIIPNIGSR PWVRGLSSRI SIYWTIVKPG

H3 HA2

The amino acid sequence of H3 HA21 is provided below, as SEQ ID NO: 174Residue N12 shown in a dash box, is bound by Ab 044 but not by FI6;Residues G1, L2, F3, G4, and D46 shown in dotted boxes, are bound by FI6but not by Ab 044; residues A7, E11, I18, D19, G20, W21, L38, K39, T41,Q42, A43, I45, I48, N49, L52, N53, 156, and E57, shown in solid boxes,are bound by both Ab 044 and FI6.

(SEQ ID NO: 174)

EKFHQIEKEF SEVEGRIQDL EKYVEDTKID LWSYNAELLV ALENQHTIDL TDSEMNKLFEKTRRQLRENA EEMGNGCFKI YHKCDNACIE SIRNGTYDHD VYRDEALNNR FQIKG

H1 residues that bind Ab 044 and H1 residues that bind FI6 are discussedbelow.

H1 HA1 The amino acid sequence of H1 HA1 is provided below, as SEQ IDNO: 181. Residues H31, N279, and S292 shown in dashed boxes, are boundby Ab 044 but not by FI6. Residues Q328 and S329 shown in dotted boxes,are bound by FI6 but not by Ab 044. Residues T319, R322, and 1324 shownin solid boxes, are bound by both Ab 044 and FI6.

(SEQ ID NO: 181)

EDSHNGKLCK LKGIAPLQLG KCNIAGWLLG NPECDLLLTASSWSYIVETS NSENGTCYPG DFIDYEELRE QLSSVSSFEKFEIFPKTSSW PNHETTKGVT AACSYAGASS FYRNLLWLTKKGSSYPKLSK SYVNNKGKEV LVLWGVHHPP TGTDQQSLYQNADAYVSVGS SKYNRRFTPE IAARPKVRDQ AGRMNYYWTLLEPGDTITFE ATGNLIAPWY AFALNRGSGS GIITSDAPVH

H1 HA2

The amino acid sequence of H1 HA2 is provided below, as SEQ ID NO: 182.Residues G12 shown in a dashed box, is bound by Ab 044 but not by FI6.Residues G1, L2, F3, G4, and D46 shown in dotted boxes, are bound by F16but not by Ab 044. Residues A7, E11, I18, D19, G20, W21, Q38, K39, T41,Q42, N43, I45, I48, T49, V52, N53, 156, and E57 shown in solid boxes,are bound by both Ab 044 and F16.

(SEQ ID NO: 182)

LNKKVDDGFL DIWTYNAELL VLLENERTLD FHDSNVRNLY EKVKSQLKNN AKEIGNGCFE FYHKCDDACM ESVRNGTYDYPKYSEESKLN REEIDGVKLE SMGVYQILAI YSTVASSLVL LVSLGAISFW MCSNGSLQCR ICI

A three dimensional representation of H3 HA with the amino acidsresidues that are predicted to be part of Ab 044 epitope but not part ofF16's epitope highlighted (i.e., the highlighted amino acids are uniqueto Ab 044's epitope) is depicted in FIG. 26 of International PublicationNo. WO2013/170139 or U.S. Application Publication No. 2013/0302349. Athree dimensional representation of H3 HA with the amino acid residuesthat are part of F16's epitope but not predicted to be part of Ab 044'sepitope highlighted is depicted in FIG. 27 of International PublicationNo. WO2013/170139 or U.S. Application Publication No. 2013/0302349.

Diagnostic Methods

The methods described herein can further include a diagnostic step asdescribed herein. The binding agents, e.g., antibody molecules, providedherein are useful for identifying the presence of influenza in abiological sample, e.g., a patient sample, such as a fluid sample, e.g.,a blood, serum, saliva, mucous, or urine sample, or a tissue sample,such as a biopsy. In one embodiment, a patient sample is contacted witha binding agent, e.g., an antibody molecule, featured in the disclosure,and binding is detected. Binding can be detected with a number offormats and means of detection, e.g., with an antigen capture assay,such as an ELISA assay or Western blot, or an immunohistochemistryassay. In some embodiments, the binding agent, e.g., an antibodymolecule, is provided, e.g., coupled to an insoluble matrix, e.g., abead or other substrate, and a detection molecule used to detect bindingof HA.

Binding of binding agent, e.g., antibody molecule, to HA, can bedetected with a reagent comprising a detectable moiety, e.g., a reagent,e.g., an antibody, which binds the binding agent, e.g., antibodymolecule. In some embodiments, the binding agent, e.g., antibodymolecule, has a detectable moiety. Suitable detectable moieties includeenzymes (e.g., horseradish peroxidase, beta-galactosidase, luciferase,alkaline phosphatase, acetylcholinesterase, glucose oxidase and thelike), radiolabels (e.g., ³H, ¹⁴C, ¹⁵N, ³⁵S, ⁹⁰Y, ⁹⁹Tc, ¹¹¹In, ¹²⁵I,¹³¹I), haptens, fluorescent labels (e.g., FITC, rhodamine, lanthanidephosphors, fluorescein, fluorescein isothiocyanate, rhodamine,5-dimethylamine-1-napthalenesulfonyl chloride, phycoerythrin and thelike), phosphorescent molecules, chemiluminescent molecules,chromophores, luminescent molecules, photoaffinity molecules, coloredparticles or affinity ligands, such as biotin, predetermined polypeptideepitopes recognized by a secondary reporter (e.g., leucine zipper pairsequences, or binding sites for secondary antibodies, metal bindingdomains, epitope tags). In some embodiments, labels are attached byspacer arms of various lengths to reduce potential steric hindrance.

In some embodiments, a human is tested for presence of influenza virusbe a method described herein, and if the test is positive, a bindingagents, e.g., antibody molecules, e.g., an antibody, provided herein, isadministered. The binding agents, e.g., antibody molecules, e.g., anantibody, provided herein can be used for cytology assays, such as toidentify an HA in a cell. The assay can be a colorimetric assay. Abiological sample from a normal (non-infected) individual is used as acontrol. The diagnostic assay can be performed in vitro. The diagnosticassay can also be performed to determine infection of cells in culture,e.g., of mammalian cells in culture. The antibody molecules can be usedin in vitro assays.

Because the antibody molecules featured herein bind a broad spectrum ofHA subtypes, the diagnostic assays featured in the disclosure can detectthe presence of influenza virus in patients infected with a variety ofdistinct strains of influenza. A patient sample can be further testedwith subtype specific antibodies, or other assays (e.g., RFLP(Restriction Fragment Length Polymorphism), PCR (Polymerase ChainReaction), RT-PCR (Reverse Transcription coupled to Polymerase ChainReaction), Northern blot, Southern blot or DNA sequencing) to furtherdetermine the particular strain of virus. In one embodiment, a patientdetermined to be infected with influenza A can be further administeredan antibody molecule featured in the disclosure, to treat the infection.Also provided are solid substrates, e.g., beads, dipsticks, arrays, andthe like, on which is disposed a binding agent, e.g., antibody molecule.

Kits

A binding agent, e.g., an antibody molecule, disclosed herein, e.g.,generated by the methods described herein, can be provided in a kit,e.g., for use in a method described herein. The kit can include one ormore other components, e.g., containers, buffers or other diluents,delivery devices, and the like.

In one embodiment, the kit includes materials for administering anantibody molecule to a subject, such as for treatment or prevention ofinfection by influenza viruses. For example, the kit can include one ormore or all of: (a) a container that contains a composition thatincludes an antibody molecule, optionally (b) a container that containsa composition that includes a second therapeutic agent, and optionally(c) informational material. In another embodiment, the kit includesmaterials for using an antibody molecule in a diagnostic assay, such asfor detection of HA in a biological sample. For example, the kit caninclude one or more or all of: (a) a container that contains acomposition that includes an antibody molecule, optionally (b) acontainer that contains a reagents, e.g., labeled with a detectablemoiety, to detect the antibody, e.g., for use in an ELISA orimmunohistochemistry assay, and optionally (c) informational material.In other embodiments, the kit comprises a binding agent, e.g., antibodymolecule, comprising a detectable moiety.

In an embodiment, the kit comprises a solid substrate, e.g., bead,dipstick, array, and the like, on which is disposed a binding agent,e.g., antibody molecule. The informational material can be descriptive,instructional, marketing or other material that relates to the methodsdescribed herein and/or the use of the agents for therapeutic benefit,or for a diagnostic assay. The informational material of the kits is notlimited in its form. In one embodiment, the informational material caninclude information about production of the antibody, concentration,date of expiration, batch or production site information, and so forth.In one embodiment, the informational material relates to methods ofadministering the antibody, e.g., in a suitable dose, dosage form, ormode of administration (e.g., a dose, dosage form, or mode ofadministration described herein), to treat a subject who has aninfection, e.g., viral infection or secondary infection (e.g., secondarybacterial infection). In another embodiment, the informational materialrelates to methods for using the antibody molecule for a diagnosticassay, e.g., to detect the presence of influenza viruses in a biologicalsample. The information can be provided in a variety of formats,including printed text, computer readable material, video recording, oraudio recording, or information that provides a link or address tosubstantive material. In addition to the agent, the composition in thekit can include other ingredients, such as a solvent or buffer, astabilizer, or a preservative. The agent can be provided in any form,e.g., a liquid, dried or lyophilized form, and substantially pure and/orsterile. When the agents are provided in a liquid solution, the liquidsolution typically is an aqueous solution. When the agents are providedas a dried form, reconstitution generally is by the addition of asuitable solvent. The solvent, e.g., sterile water or buffer, canoptionally be provided in the kit.

The kit can include one or more containers for the composition orcompositions containing the agents. In some embodiments, the kitcontains separate containers, dividers or compartments for thecomposition and informational material. For example, the composition canbe contained in a bottle, vial, or syringe, and the informationalmaterial can be contained in a plastic sleeve or packet. In otherembodiments, the separate elements of the kit are contained within asingle, undivided container. For example, the composition is containedin a bottle, vial or syringe that has attached thereto the informationalmaterial in the form of a label. In some embodiments, the kit includes aplurality (e.g., a pack) of individual containers, each containing oneor more unit dosage forms (e.g., a dosage form described herein) of theagents. The containers can include a combination unit dosage, e.g., aunit that includes both the antibody molecule and the second oradditional agent, such as in a desired ratio. For example, the kit caninclude a plurality of syringes, ampoules, foil packets, blister packs,or medical devices each containing, for example, a single combinationunit dose. The containers of the kits can be air tight, waterproof(e.g., impermeable to changes in moisture or evaporation), and/orlight-tight.

The kit optionally includes a device suitable for administering thecomposition, e.g., a syringe or device for delivering particles oraerosols, e.g., an inhaler, a spray device, or a dropper or othersuitable delivery device. The device can be provided pre-loaded with oneor both of the agents or can be empty but suitable for loading. Theinvention is further illustrated by the following examples, which shouldnot be construed as further limiting.

Other Embodiments

The antibody molecule described herein can be encoded by a nucleic acidmolecule, e.g., an isolated nucleic acid molecule. In an embodiment, thenucleic acid molecule comprises a nucleotide sequence that encodes aheavy chain immunoglobulin variable region segment featured in thedisclosure. In another embodiment, the nucleic acid molecule comprises anucleotide sequence encoding a light chain immunoglobulin variableregion segment featured in the disclosure. In yet another aspect, thenucleic acid molecule comprises a nucleotide sequence that encodes aheavy chain immunoglobulin variable region segment featured in thedisclosure and a light chain immunoglobulin variable region segmentfeatured in the disclosure. In an embodiment, the nucleic acid moleculeis present in a vector, e.g., a recombinant vector (e.g., an expressionvector). In an embodiment, the vector comprises a nucleic acid moleculethat comprises a nucleotide sequence that encodes a heavy chainimmunoglobulin variable region segment featured in the disclosure, anucleotide sequence that encodes a light chain immunoglobulin variableregion segment featured in the disclosure, or both. In one embodiment,the nucleic acid molecule in the recombinant vector includes anucleotide sequence encoding (a) a heavy chain immunoglobulin variableregion segment comprising the amino acid sequence of: S-Y-A-M-H (SEQ IDNO:68) in CDR1; V-V-S-Y-D-G-N-Y-K-Y-Y-A-D-S-V-Q-G (SEQ ID NO:69) inCDR2; and D-S-R-L-R-S-L-L-Y-F-E-W-L-S-Q-G-Y-F-N-P (SEQ ID NO:70) inCDR3; and (b) a light chain immunoglobulin variable region segmentcomprising the amino acid sequence of: Q-S-I-T-F-D-Y-K-N-Y-L-A (SEQ IDNO:145) in CDR1; W-G-S-Y-L-E-S (SEQ ID NO:72) in CDR2; andQ-Q-H-Y-R-T-P-P-S (SEQ ID NO:73) in CDR3.

In an embodiment, the antibody molecule described herein is producedfrom a cell containing a recombinant vector featured in the disclosure,such as a recombinant vector comprising a nucleic acid sequence thatencodes a heavy chain immunoglobulin variable region, or a recombinantvector comprising a nucleic acid sequence that encodes a light chainimmunoglobulin variable region. In one embodiment, the cell contains arecombinant vector comprising a nucleic acid sequence that encodes aheavy chain immunoglobulin variable region, and a recombinant vectorcomprising a nucleic acid sequence that encodes a light chainimmunoglobulin variable region. In yet another embodiment, the cellcontains a recombinant vector comprising a nucleic acid sequence thatencodes a heavy chain immunoglobulin variable region, and a nucleic acidsequence that encodes a light chain immunoglobulin variable region. Inan embodiment, the antibody molecule is produced, e.g., by providing ahost cell comprising a nucleic acid sequence expressing a heavy chainsegment and a nucleic acid sequence expressing a light chain segment,and expressing the nucleic acids in the host cell. In one embodiment,the nucleic acid sequence expressing the heavy chain segment and thenucleic acid sequence expressing the light chain segment are on the samerecombinant expression vector. In another embodiment, the nucleic acidsequence expressing the heavy chain segment and the nucleic acidsequence expressing the light chain segment are on separate recombinantexpression vectors.

In an embodiment, a pharmaceutical composition containing an antibodymolecule featured in the disclosure, and a pharmaceutically acceptablecarrier, is used in a method described herein.

In an embodiment, the method described herein treats or prevents aninfection with an influenza virus (e.g., an influenza A virus, e.g., aGroup 1 strain, e.g., an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004, or an influenza B virus,e.g., B/Wisconsin/1/2010), in a subject, e.g., a human subject, thatcomprises: administering a binding agent, e.g., an antibody molecule,featured in the disclosure to a subject, e.g., human subject, in needthereof. In one embodiment, the influenza A virus is an H1, H5, H9, H3or H7 strain, such as an H1N1 strain, an H3N2 strain, or an H5N1 strainof influenza A virus. In an embodiment, the administration results in,or correlates with, one or more of a reduction in the incidence orseverity of a symptom or manifestation of an influenza infection, or thedelay or onset of a symptom or manifestation of an influenza infection.In an embodiment, the administration results in, or correlates with, oneor more of a reduction in the incidence or severity of a symptom ormanifestation of a secondary infection, or the delay or onset of asymptom or manifestation of a secondary infection. In some embodiments,the subject, e.g., a human subject, has been administered, or the methodcomprises, administering, or recommending the administration of, asecond or additional therapy.

In some embodiments, the antibody molecule is administered incombination with a second or additional agent or therapy. In someembodiments, the second or additional therapy comprises administrationof a vaccine or an anti-viral therapy, e.g., an anti-NA or an anti-M2therapy. In an embodiment, the second or additional therapy comprises anadministration of a vaccine, e.g., a vaccine described herein or amixture (a.k.a. a cocktail) of influenza peptides to stimulate thepatient's immune system to prevent infection with particular strains ofinfluenza A. In an embodiment, the second or additional agent comprisesadministering an anti-viral agent, a pain reliever, ananti-inflammatory, an antibiotic, a steroidal agent, a secondtherapeutic antibody molecule (e.g., an anti-HA antibody), an adjuvant,a protease or glycosidase (e.g., sialidase). In an embodiment, thesecond or additional agent comprises, acyclovir, ribavirin, amantadine,remantidine, a neuraminidase inhibitor (e.g., zanamivir (Relenza®),oseltamivir (Tamiflu®), laninamivir, peramivir), or rimantadine.

In an embodiment, the second or additional agent comprises a secondantibody molecule, e.g., Ab 67-11 (U.S. Provisional application No.61/645,453, FI6 (U.S. Application Publication No. 2010/0080813), FI28(U.S. Application Publication No. 2010/0080813), C179 (Okuno et al., J.Virol. 67:2552-8, 1993), F10 (Sui et al., Nat. Struct. Mol. Biol.16:265, 2009), CR9114 (Dreyfus et al., Science 337:1343, 2012), orCR6261 (see, e.g., Ekiert et al., Science 324:246, 2009). Thus, Ab 044can be used in combination of any of those antibodies. In an embodiment,the second or additional agent comprises a second or additional bindingagent, e.g., antibody molecule, e.g., an anti-HA antibody, e.g., ananti-HA antibody disclosed herein. E.g., two or more of Ab 044, Ab 069,Ab 032, and Ab 031 can be administered. E.g., Ab 044 can be administeredin combination with Ab 069 or Ab 032. In the case of combinations, twoagents can be administered as part of the same dosage unit oradministered separately. Other exemplary agents useful for treating thesymptoms associated with influenza infection are acetaminophen,ibuprofen, aspirin, and naproxen.

In an embodiment, the binding agent, e.g., an antibody molecule, isadministered to a human subject suffering from or susceptible to aninfluenza infection. In an embodiment, the binding agent, e.g., anantibody molecule, is administered prior to known exposure to influenza,or to particular influenza subtypes or strains. In an embodiment, thebinding agent, e.g., an antibody molecule, is administered prior tomanifestation of effects or symptoms of influenza infection, or to oneor more particular effects manifestation of effects or symptoms ofinfluenza infection. In an embodiment, the binding agent, e.g., anantibody molecule, is administered after known exposure to influenza, orto particular influenza subtypes or strains. In an embodiment, thebinding agent, e.g., an antibody molecule, is administered aftermanifestation of effects or symptoms of influenza infection, or afterobservation of one or more particular effects manifestation of effectsor symptoms of influenza infection. In an embodiment, the binding agent,e.g., an antibody molecule, is administered in response to, or to treator prevent, a manifestation of an effect or a symptom of influenzainfection, e.g., inflammation, fever, nausea, weight loss, loss ofappetite, rapid breathing, increase heart rate, high blood pressure,body aches, muscle pain, eye pain, fatigue, malaise, dry cough, runnynose, and/or sore throat.

In an embodiment, the method further comprises, testing the humansubject for the influenza virus, e.g., with a method disclosed herein.In some embodiments, the administration is responsive to a positive testfor influenza.

In an embodiment, the method described herein treats a subject, e.g., ahuman subject, an infected with an influenza virus (e.g., an influenza Avirus, e.g., a Group 1 strain, e.g., an H1N1 strain, e.g., A/SouthCarolina/1/1918, A/Puerto Rico/08/1934, or A/California/04/2009, or anH5N1 strain, e.g., A/Indonesia/5/2005 or A/Vietnam/1203/2004, or aninfluenza B virus, e.g., B/Wisconsin/1/2010) by administering a bindingagent, e.g., an antibody molecule, featured in the disclosure. Forexample, the influenza A virus is an H1, H5, H9, H3 or H7 strain, suchas an H1N1 strain, an H3N2 strain, or an H5N1 strain of influenza Avirus. In one embodiment, a binding agent, e.g., an anti-HA antibody,described herein is administered instead of a vaccine for prevention ofinfluenza. In another embodiment, the binding agent, e.g., anti-HAantibody molecule, is administered in combination with (simultaneouslyor sequentially with) a vaccine for prevention of the flu.

In an embodiment, the method further comprises detecting influenza(e.g., influenza A or influenza B) virions in a biological sample, suchas by contacting the sample with a binding agent, e.g., an antibodymolecule, featured in the disclosure, and then detecting the binding ofthe antibody molecule to the sample. In one embodiment, the method ofdetecting the influenza virus (e.g., influenza A or influenza B virus)is performed in vitro.

In an embodiment, the method further includes: (a) providing a samplefrom a patient; (b) contacting the sample with a binding agent, e.g., anantibody molecule, featured in the disclosure, and (c) determiningwhether the binding agent, e.g., an antibody molecule, featured in thedisclosure binds a polypeptide in the sample, where if the bindingagent, e.g., an antibody molecule, binds a polypeptide in the sample,then the patient is determined to be infected with an influenza virus(e.g., an influenza A virus, e.g., a Group 1 strain, e.g., an H1N1strain, e.g., A/South Carolina/1/1918, A/Puerto Rico/08/1934, orA/California/04/2009, or an H5N1 strain, e.g., A/Indonesia/5/2005 orA/Vietnam/1203/2004, or an influenza B virus, e.g., e.g.,B/Wisconsin/1/2010). In one embodiment, the patient is determined to beinfected with an influenza virus (e.g., an influenza A virus, e.g., aGroup 1 strain, e.g., an H1N1 strain, e.g., A/South Carolina/1/1918,A/Puerto Rico/08/1934, or A/California/04/2009, or an H5N1 strain, e.g.,A/Indonesia/5/2005 or A/Vietnam/1203/2004, or an influenza B virus,e.g., B/Wisconsin/1/2010), and the patient is further administered abinding agent, e.g., an antibody molecule, disclosed herein, e.g., thebinding agent, e.g., an antibody molecule, with which the test wasperformed.

In an embodiment, the method further includes inducing immunity to oneor more influenza strains, or preventing, delaying or reducing infectionwith an influenza strain, or symptom thereof, in a vertebrate, e.g., ahuman. The method comprises administering to the vertebrate, e.g., ahuman, a broad range vaccine, or broad range immunogen, describedherein.

In an embodiment, the broad range vaccine, or broad range immunogen,induces an immune response against, or confers protection against, oneor more influenza strains. In an embodiment, the broad range vaccine, orbroad range immunogen, induces an immune response against, or confersprotection against, two influenza strains. In an embodiment, the broadrange vaccine, or broad range immunogen, induces an immune responseagainst, or confers protection against, two Group 1 influenza strains.In an embodiment, the broad range vaccine induces, or broad rangeimmunogen, an immune response against, or confers protection against, atleast one Group 1 strain, and a second strain from Group 1, Group 2 oran influenza B strain. In one embodiment, the influenza A virus is anH1, H5, H9, H3 or H7 strain, such as an H1N1 strain, an H3N2 strain, oran H5N1 strain of influenza A virus.

In an embodiment, the administration results in, or correlates with, oneor more of: a reduction in the chance of an infection, a reduction inthe incidence or severity of a symptom or manifestation of an influenzainfection, or the delay or onset of a symptom or manifestation of aninfluenza infection. In an embodiment, the administration results in, orcorrelates with, one or more of: a reduction in the incidence orseverity of a symptom or manifestation of a secondary infection, or thedelay or onset of a symptom or manifestation of a secondary infection.

In some embodiments, the subject, e.g., a human subject, has beenadministered, or the method comprises, administering, or recommendingthe administration of, a second or additional therapy. In someembodiments, the broad range vaccine is administered in combination witha second or additional agent or therapy. In some embodiments, the secondor additional agent comprises administration of another vaccine oranother anti-viral therapy, e.g., an anti-NA or an anti-M2 therapy. Inan embodiment, the second or additional agent comprises administrationof a vaccine comprising a mixture (a.k.a. a cocktail) of influenzapeptides to stimulate the patient's immune system to prevent infectionwith particular strains of influenza A. In an embodiment, the second oradditional agent comprises administering an anti-viral agent, a painreliever, an anti-inflammatory, an antibiotic, a steroidal agent, asecond therapeutic antibody molecule (e.g., an anti-HA antibody), anadjuvant, a protease or glycosidase (e.g., sialidase). In an embodiment,the second or additional agent comprises, acyclovir, ribavirin,amantadine, remantidine, a neuraminidase inhibitor (e.g., zanamivir(Relenza®), oseltamivir (Tamiflu®), laninamivir, peramivir), orrimantadine. In an embodiment, the second or additional agent comprisesan antibody molecule, e.g., Ab 67-11 (U.S. Provisional application No.61/645,453, FI6 (U.S. Application Publication No. 2010/0080813), FI28(U.S. Application Publication No. 2010/0080813), C179 (Okuno et al., J.Virol. 67:2552-8, 1993), F10 (Sui et al., Nat. Struct. Mol. Biol.16:265, 2009), CR9114 (Dreyfus et al., Science 337:1343, 2012), orCR6261 (Ekiert et al., Science 324:246, 2009). In an embodiment, thesecond or additional agent comprises an antibody molecule disclosedherein, e.g., an antibody molecule selected from Ab-044, Ab 069, Ab 032,and Ab 031 antibody molecules. In the case of combinations, two agentscan be administered as part of the same dosage unit or administeredseparately. Other exemplary second or additional agents useful fortreating the symptoms associated with influenza infection areacetaminophen, ibuprofen, aspirin, and naproxen.

In an embodiment, the method further comprises, testing the humansubject for the influenza virus, e.g., with a method disclosed herein.In some embodiments, the administration is responsive to a positive testfor influenza. In an embodiment, the method further comprises reducingthe severity of influenza in a population. The method includesadministering a broad range vaccine, or broad range immunogen, tosufficient individuals in the population to prevent or decrease thechance of influenza virus transmission to another individual in thepopulation.

Anti-HA antibody molecules described herein are also disclosed inInternational Publication No. WO2013/170139, U.S. Pat. Nos. 8,877,200,9,096,657, and U.S. Patent Application Publication No. US 2013/0302349.The contents of the aforesaid publications are incorporated by referencein their entirety.

TABLE 4C Nucleic acid and amino acid sequences SEQ ID NO. Lab no. SourceComment Sequence 1 n.a. Table 2 Consensus AA sequence of HC [S/T]Y[A/G]MH CDR1 2 n.a. Table 2 Consensus AA sequence of HC V[I/V/L]S[Y/F]DG[S/N][Y/N][K/R]YYADSVQG CDR2 3 n.a. Table 2Consensus AA sequence of HC D[S/T][R/K/Q]LR[S/T]LLYFEWLS[Q/S]G[Y/L/V][F/L][N/D][P/Y] CDR3 4 n.a.Table 2 Consensus AA sequence of LC Q[S/T][V/L/I][T/S][Y/F/W][N/S/D]YKNYLA CDR1 170 n.a. Table 2Consensus AA sequence of LC Q[S/T][V/L/I][T/S][Y/F/W][N/S/D/Q/R/E]YKNYLA CDR1 5 n.a. Table 2Consensus AA sequence of LC  W[A/G]S[T/A/Y/H/K/D][R/L]E[S/T] CDR2 6 n.a.Table 2 Consensus AA sequence of LC  QQ[Y/H]YRTPP[T/S] CDR3 7 n.a.Table 2 Consensus AA sequence of HC FR1[E/Q]VQLLE[S/T]GGGLVKPGQSLKLSCAASGFTF[S/T] 8 n.a. Table 2Consensus AA sequence of HC FR2 WVRQPPGKGLEWVA 9 n.a. Table 2Consensus AA sequence of HC FR3 RFTISRDNSKNTLYLQMNSLRAEDTAVYYCAK 10 n.a.Table 2 Consensus AA sequence of HC FR4 WG[A/Q]G[T/A][T/M][L/V]TVSS 11n.a. Table 2 Consensus AA sequence of LC FR1[E/D]I[V/Q]MTQSP[D/S][S/T][L/V][A/S][V/A][S/T][L/V/R]G[E/D]R[A/V] 12n.a. Table 2 Consensus AA sequence of LC FR2 WYQQKPG[Q/K][P/A]PKLLIY 13n.a. Table 2 Consensus AA sequence of LC FR3GVP[D/E/S]RFSGSGSGTDFTLTISSLQ[A/P]ED[V/F/K/D]A[V/T]YYC 14 n.a. Table 2Consensus AA sequence of LC FR4 FG[G/Q/T/S/N]GTK[L/V][D/E]IK 15 15Table 3, AA sequence of HC VR  of Ab EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVISYDGSYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH15 Table 4A, A18; entire HC domain is in RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS FIG. 2FIG. 1; ID version is in FIG.  13; NT sequence is in Example 1 28 28Table 3, AA sequence of LC VR of Ab EIVMTQSPDSLAVSLGERATINCKSSQSVTYNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL28 Table 4A A18; entire LC domain is in  VAVYYCQQYYRTPPTFGGGTKLDIKFIG. 3 FIG. 1; ID version is in FIG.  14; NT sequence is in Example 1 1616 Table 3 AA sequence of HC VR of Abs EVQLLESGGGLVKPGQSLKLSCAASGFTFSSYGMHWVRQPPGKGLEWVAVVSYDGSNKYYADSVQGRFTISRDNSKNTLYLQMNSLVH16 Table 4A 014, 028; ID version is in RAEDTAVYYCAKDTKLRSLLYFEWLSSGLLDYWGQGAMVTVSS FIG. 2FIG. 13; NT sequence is in  Example 1 29 29 Table 3AA sequence of LC VR of Abs 014,EIVMTQSPDSLAVSLGERATINCKSSQSVTFSYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL29 Table 4A 154, 157; ID version is in FIG. VAVYYCQQYYRTPPTFGGGTKLDIKFIG. 3 14; NT sequence is in Example 1 30 30 Table 3AA sequence of LC VR of Abs 028,EIVMTQSPDSLAVSLGERATINCKSSQSVTFDYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL30 Table 4A 155; ID version is in FIG. 14;  VAVYYCQQYYRTPPTFGGGTKLDIKFIG. 3 NT sequence is in Example 1 17 17 Table 3AA sequence of HC VR of Abs 001,EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH17 Table 4A 009, 017, 025, 160, 186, 187, RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS FIG. 2188, 189, 190, 191, 192, 193,  202, 211; ID version is in FIG. 13; 31 31Table 3 AA sequence of LC VR of Abs 001,EIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL31 Table 4A 002, 003; ID version is in FIG. VAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3 14; 18 18 Table 3 AA sequence of HC VR of Abs 002,EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVLSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH18 Table 4A 010, B18, 026, 203, 212; ID RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS FIG. 2version is in FIG. 13; 19 19 Table 3 AA sequence of HC VR of Abs 003,EVQLLESGGGLVKPGQSLKLSCAASGFTFTTYAMHWVRQPPGKGLEWVAVLSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH19 Table 4A 011, 019, 027, 194, 195, 196, RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS FIG. 2197, 198, 199, 200, 204, 213;  ID version is in FIG. 13; 32 32 Table 3AA sequence of LC VR of Abs 009,EIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL32 Table 4A 010, 011; ID version is in FIG. VAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3 14; 33 33 Table 3 AA sequence of LC VR of Abs 017,EIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYFASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL33 Table 4A B18, 019; ID version is in FIG. VAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3 14; 34 34 Table 3 AA sequence of LC VR of Abs 025,EIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYFASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL34 Table 4A 026, 027, 086; ID version is in VAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3 FIG. 14; 20 20 Table 3 AA sequence of HC VR of Ab 086;EVQLLESGGGLVKPGQSLKLSCAASGFTFTTYAMHWVRQPPGKGLEWVAVVSFDGNNRYYADSVQGRFTISRDNSKNTLYLQMNSLVH20 Table 4A ID version is in FIG. 13;RAEDTAVYYCAKDSQLRSLLYFEWLSSGVLDYWGQGAMVTVSS FIG. 2 21 21 Table 3AA sequence of HC VR of Abs 154,EVQLLESGGGLVKPGQSLKLSCAASGFTFSSYGMHWVRQPPGKGLEWVAVVSYDGNNKYYADSVQGRFTISRDNSKNTLYLQMNSLVH21 Table 4A 155; ID version is in FIG. 13;RAEDTAVYYCAKDSKLRSLLYFEWLSSGLLDYWGQGAMVTVSS FIG. 2 22 22 Table 3AA sequence of HC VR of Abs 157,EVQLLESGGGLVKPGQSLKLSCAASGFTFTTYAMHWVRQPPGKGLEWVAVVSYDGNNKYYADSVQGRFTISRDNSKNTLYLQMNSLVH22 Table 4A 159; ID version is in FIG. 13;RAEDTAVYYCAKDSKLRSLLYFEWLSSGLLDYWGQGAMVTVSS FIG. 2 35 35 Table 3AA sequence of LC VR of Ab 159;EIVMTQSPDSLAVSLGERATINCKSSQSVTWSYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL35 Table 4A ID version is in FIG. 14; VAVYYCQQYYRTPPTFGGGTKLDIK FIG. 336 36 Table 3 AA sequence of LC VR of Ab 160;EIVMSQSPDTLAVTLGERASINCKSSQTVTFNYKNYLAWYQQKPGQPPKVLIYWASARETGVPERFSGSGSGTDFTLTISSLQAEDVL36 Table 4A ID version is in FIG. 14; VAVYYCQQHYRTPPSFGQGTKLEIK FIG. 337 37 Table 3 AA sequence of LC VR of Abs 186,EIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL37 Table 4A 194; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGTGTKLDIK38 38 Table 3 AA sequence of LC VR of Abs 187,EIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL38 Table 4A 195; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGSGTKLDIKFIG. 3 39 39 Table 3 AA sequence of LC VR of Abs 188,EIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL39 Table 4A 196; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3 40 40 Table 3 AA sequence of LC VR of Abs 189,EIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL40 Table 4A 197; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGNGTKLDIKFIG. 3 41 41 Table 3 AA sequence of LC VR of Abs 190,EIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL41 Table 4A 198; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGTGTKLDIKFIG. 3 42 42 Table 3 AA sequence of LC VR of Abs 191,EIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL42 Table 4A 199; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGSGTKLDIK43 43 Table 3 AA sequence of LC VR of Abs 192,EIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL43 Table 4A 200; ID version is in FIG. 14; VAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3 44 44 Table 3 AA sequence of LC VR of Abs 193;EIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL44 Table 4A ID version is in FIG. 14; VAVYYCQQHYRTPPSFGNGTKLDIK FIG. 345 45 Table 3 AA sequence of LC VR of Abs 202,DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL45 Table 4A 203, 204, 210, 031, 032, 033,  FATYYCQQHYRTPPSFGQGTKVEIKFIG. 3 034; ID version is in FIG. 14; NT sequence is in Example 1 46 46Table 3 AA sequence of LC VR of Abs 211,DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLGWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL46 Table 4A 212, 213, 219, 037, 038, 039,  FATYYCQQHYRTPPSFGQGTKVEIKFIG. 3 040; ID version is in FIG. 14; 23 23 Table 3AA sequence of HC VR of Abs 210,EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH23 Table 4A 219; ID version is in FIG. 13;RAEDTAVYYCAKDSKLRSLLYFEWLSQGYFNPWGAGTTLTVSS FIG. 2 24 24 Table 3AA sequence of HC VR of Abs EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH24 Table 4A A001, A002, A003, A010, A011, RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTLTVSS FIG. 2031, 037; ID version is in FIG. 13; NT sequence is in Example 1 47 47Table 3 AA sequence of LC VR of Abs DIVMTQSPDTLAVTLGERATIQCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTITSLQAEDVL47 Table 4A A001, 004, 007, 016; ID version VAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3 is in FIG. 14; 48 48 Table 3 AA sequence of LC VR of Abs DIVMTQSPDTVAVTVGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL48 Table 4A 002, 005, 008, A017; ID version VAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3 is in FIG. 14; 25 25 Table 3 AA sequence of HC VR of Abs 004,QVQLLETGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH25 Table 4A 005, 006, 012, 013, 032, 038, RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTLTVSS FIG. 2043, 044, 045, 046, 047, 048,  049, 050, 051, 052, 067, 068, 069, 070, 073, 074, 075, 076,  077; ID version is in FIG. 13;NT sequence is in Example 1 49 49 Table 3 AA sequence of LC VR of Abs DIVMTQSPDTVAVTLGERATIDCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL49 Table 4A A003, 006, A009, C18; ID  VAVYYCQQHYRTPPSFGQGTKLDIK FIG. 3version is in FIG. 14; 26 26 Table 3 AA sequence of HC VR of Abs 007,EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH26 Table 4A 008, A009, A14, 015, 033, 039; RAEDTAVYYCAKDSQLRTLLYFEWLSQGYFNPWGQGTTLTVSS FIG. 2ID version is in FIG. 13; 50 50 Table 3 AA sequence of LC VR of Abs DIVMTQSPDTLAVTVGERATIRCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL50 Table 4A A010 012, A14, A019; ID version VAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3 is in FIG. 14; 51 51 Table 3 AA sequence of LC VR of Ab A011,DIVMTQSPDTLAVSRGERATIDCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVL51 Table 4A 013, 015; ID version is in FIG. EAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3 14; 27 27 Table 3 AA sequence of HC VR of Abs 016,EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVH27 Table 4A A017, C18, A019, 034,040; ID RAEDTAVYYCAKDSRLRTLLYFEWLSQGYFDPWGQGTTLTVSS FIG. 2version is in FIG. 13; 60 60 Table 3 AA sequence of LC VR of Ab 043;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL60 Table 4A ID version is in FIG. 14; FATYYCQQYYRTPPSFGQGTKVEIK FIG. 352 52 Table 3 AA sequence of LC VR of Abs 044,DIQMTQSPSSLSASVGDRVTITCRSSQSITFDYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL52 Table 4A 071, 072, 078; ID version is in FATYYCQQHYRTPPSFGQGTKVEIKFIG. 3 FIG. 14; NT sequence is in  Example 1 57 57 Table 3AA sequence of LC VR of Ab 045;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL57 Table 4A ID version is in FIG. 14; VATYYCQQHYRTPPSFGQGTKVEIK FIG. 359 59 Table 3 AA sequence of LC VR of Ab 046;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL59 Table 4A ID version is in FIG. 14; DATYYCQQHYRTPPSFGQGTKVEIK FIG. 355 55 Table 3 AA sequence of LC VR of Ab 047;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSKLESGVPSRFSGSGSGTDFTLTISSLQPEDVL55 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIK FIG. 358 58 Table 3 AA sequence of LC VR of Ab 048;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL58 Table 4A ID version is in FIG. 14; KATYYCQQHYRTPPSFGQGTKVEIK FIG. 354 54 Table 3 AA sequence of LC VR of Ab 049;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSHLESGVPSRFSGSGSGTDFTLTISSLQPEDVL54 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIK FIG. 356 56 Table 3 AA sequence of LC VR of Ab 050;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSDLESGVPSRFSGSGSGTDFTLTISSLQPEDVL56 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIK 53 53Table 3 AA sequence of LC VR of Ab 051;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSTLESGVPSRFSGSGSGTDFTLTISSLQPEDVL53 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIK FIG. 361 61 Table 3 AA sequence of LC VR of Ab 052;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSTRESGVPSRFSGSGSGTDFTLTISSLQPEDVL61 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIK FIG. 3153 153 Table 3 AA sequence of LC VR of Ab 067;DIQMTQSPSSLSASVGDRVTITCRSSQSITFQYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL153 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIKFIG. 3 154 154 Table 3 AA sequence of LC VR of Ab 068;DIQMTQSPSSLSASVGDRVTITCRSSQSITFRYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL154 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIKFIG. 3 155 155 Table 3 AA sequence of LC VR of Abs DIQMTQSPSSLSASVGDRVTITCRSSQSITFEYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL155 Table 4A 069, 079; ID version is in  FATYYCQQHYRTPPSFGQGTKVEIKFIG. 14; 156 156 Table 3 AA sequence of LC VR of Ab 070;DIQMTQSPSSLSASVGDRVTITCRSSQSITFDYKNYLAWYQQKPGKAPKLLIYWGSTRESGVPSRFSGSGSGTDFTLTISSLQPEDVL156 Table 4A ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIKFIG. 3 162 162 Table 3 AA sequence of HC VR of Ab 071EVQLLESGGGLVKPGQSLKLSCAASGFSFSTYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADTVQGRFTISRDNSKNTLYLQMNSLVL162 Table 4A RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTLTVSS FIG. 17 163163 Table 3 AA sequence of HC VR of Ab 072EVQLLESGGGLRKPGQSLKLSCAASGFSFSTYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVL163 Table 4A RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTLTVSS FIG. 17 165165 Table 3 AA sequence of LC VR of Ab 073DIQMTQSPSSLSASVGDRVTITCRSSQSITWNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL165 Table 4A FATYYCQQHYRTPPSFGQGTKVEIK FIG. 17 166 166 Table 3AA sequence of LC VR of Abs DIQMTQSPSSLSASVGDRVTITCRSSQSITWDYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL166 Table 4A 074, 080 FATYYCQQHYRTPPSFGQGTKVEIK FIG. 17 167 167Table 3 AA sequence of LC VR of Ab 075DIQMTQSPSSLSASVGDRVTITCRSSQSITWQYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL167 Table 4A FATYYCQQHYRTPPSFGQGTKVEIK FIG. 17 168 168 Table 3AA sequence of LC VR of Ab 076DIQMTQSPSSLSASVGDRVTITCRSSQSITWRYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL168 Table 4A FATYYCQQHYRTPPSFGQGTKVEIK FIG. 17 169 169 Table 3AA sequence of LC VR of Abs DIQMTQSPSSLSASVGDRVTITCRSSQSITWEYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDVL169 Table 4A 077, 081 FATYYCQQHYRTPPSFGQGTKVEIK FIG. 17 164 164Table 3 AA sequence of HC VR of Abs QVQLLETGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNSLVL164 Table 4A 078, 079, 080, 081RAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTVTVSS FIG. 17 161 HC161 Table 4AAA sequence of HC VR consensus;EVQLLESGGGLVKPGQSLKLSCAASGFTFSSYGMHWVRQPPGKGLEWVAVVSYDGSNKYYADSVQGRFTISRDNSKNTLYLQMNSLFIG. 2 ID version is in FIG. 13;RAEDTAVYYCAKDSKLRSLLYFEWLSSGLLDYWGQGAMVTVSS 62 LC62 Table 4AAA sequence of LC VR consensus;DIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPEDFIG. 3 ID version is in FIG. 14; FATYYCQQHYRTPPSFGQGTKVEIK 96  15-IDTable 4B AA sequence of HC VR of Ab A18;IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVISYDGSYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 non-ID version is in FIG. 2;SLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS 110  28-ID Table 4BAA sequence of LC VR of Ab A18;IDEIVMTQSPDSLAVSLGERATINCKSSQSVTYNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 non-ID version is in FIG. 3 EDVAVYYCQQYYRTPPTFGGGTKLDIK 97 16-ID Table 4B AA sequence of HC VR of Abs 014,IDEVQLLESGGGLVKPGQSLKLSCAASGFTFSSYGMHWVRQPPGKGLEWVAVVSYDGSNKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 028; non-ID version is in FIG. SLRAEDTAVYYCAKDTKLRSLLYFEWLSSGLLDYWGQGAMVTVSS 2; 111  29-ID Table 4BAA sequence of LC VR of Abs 014,IDEIVMTQSPDSLAVSLGERATINCKSSQSVTFSYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 154, 157; non-ID version is in EDVAVYYCQQYYRTPPTFGGGTKLDIKFIG. 3; 98  17-ID Table 4B AA sequence of HC VR of Ab 001,IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 009, 017, 025, 160, 186, 187, SLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS188, 189, 190, 191, 192, 193,  202, 211; non-ID version is in  FIG. 2;112  30-ID Table 4B AA sequence of LC VR of Abs 028,IDEIVMTQSPDSLAVSLGERATINCKSSQSVTFDYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 155; non-ID version is in FIG.  EDVAVYYCQQYYRTPPTFGGGTKLDIK 3;99  18-ID Table 4B AA sequence of HC VR of Abs 002,IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVLSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 010, B18, 026, 203, 212; non-IDSLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS version is in FIG. 2; 113 35-ID Table 4B AA sequence of LC VR of Ab 159; IDEIVMTQSPDSLAVSLGERATINCKSSQSVTWSYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 non-ID version is in FIG. 3; EDVAVYYCQQYYRTPPTFGGGTKLDIK 100 19-ID Table 4B AA sequence of HC VR of Abs 003,IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTTYAMHWVRQPPGKGLEWVAVLSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 011, 019, 027, 194, 195, 196, SLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSS197, 198, 199, 200, 204, 213;  non-ID version is in FIG. 2; 114  31-IDTable 4B AA sequence of LC VR of Abs 001,IDEIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 002, 003; non-ID version is in EDVAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3; 101  21-ID Table 4B AA sequence of HC VR of Abs 154,IDEVQLLESGGGLVKPGQSLKLSCAASGFTFSSYGMHWVRQPPGKGLEWVAVVSYDGNNKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 155; non-ID version is in FIG. SLRAEDTAVYYCAKDSKLRSLLYFEWLSSGLLDYWGQGAMVTVSS 2; 115  32-ID Table 4BAA sequence of LC VR of Abs 009,IDEIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 010, 011; non-ID version is in EDVAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3; 102  22-ID Table 4B AA sequence of HC VR of Abs 157,IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTTYAMHWVRQPPGKGLEWVAVVSYDGNNKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 159; non-ID version is in FIG. SLRAEDTAVYYCAKDSKLRSLLYFEWLSSGLLDYWGQGAMVTVSS 2; 116  33-ID Table 4BAA sequence of LC VR of Abs 017,IDEIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYFASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 B18, 019; non-ID version is in  EDVAVYYCQQHYRTPPSFGGGTKLDIKFIG. 3; 103  20-ID Table 4B AA sequence of HC VR of Ab 086; IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTTYAMHWVRQPPGKGLEWVAVVSFDGNNRYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 non-ID version is in FIG. 2;SLRAEDTAVYYCAKDSQLRSLLYFEWLSSGVLDYWGQGAMVTVSS 117  34-ID Table 4BAA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYFASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 025, 026, 027, 086; non-ID  EDVAVYYCQQHYRTPPSFGGGTKLDIKversion is in FIG. 3; 104  23-ID Table 4B AA sequence of HC VR of Abs IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 210, 219; non-ID version is in SLRAEDTAVYYCAKDSKLRSLLYFEWLSQGYFNPWGAGTTLTVSS FIG. 2; 118  36-IDTable 4B AA sequence of LC VR of Ab 160;IDEIVMSQSPDTLAVTLGERASINCKSSQTVTFNYKNYLAWYQQKPGQPPKVLIYWASARETGVPERFSGSGSGTDFTLTISSLQAFIG. 14 non-ID version is in FIG. 3; EDVAVYYCQQHYRTPPSFGQGTKLEIK 105 24-ID Table 4B AA sequence of HC VR of Abs IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 A001, A002, A003, A010, A011, SLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTLTVSS031, 037; non-ID version is in  FIG. 2; 119  45-ID Table 4BAA sequence of LC VR of Abs IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 202, 203, 204, 210, 031, 032,  EDFATYYCQQHYRTPPSFGQGTKVEIK033, 034; non-ID version is in FIG. 3; 106  25-ID Table 4BAA sequence of HC VR of Abs IDQVQLLETGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 004, 005, 006, 012, 013, 032, SLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGQGTTLTVSS038, 043, 044, 045, 046, 047,  048, 049, 050, 051, 052, 067, 068, 069, 070, 073, 074, 075,  076, 077; non-ID version is in FIG. 2;120  46-ID Table 4B AA sequence of LC VR of Abs IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLGWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 211, 212, 213, 219, 037, 038,   EDFATYYCQQHYRTPPSFGQGTKVEIK039, 040; non-ID version is in FIG. 3; 107  26-ID Table 4BAA sequence of HC VR of Abs IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 007, 008, A009, A14, 015, 033,SLRAEDTAVYYCAKDSQLRTLLYFEWLSQGYFNPWGQGTTLTVSS039; non-ID version is in FIG. 2; 121  37-ID Table 4BAA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 186, 194; non-ID version is in EDVAVYYCQQHYRTPPSFGTGTKLDIKFIG. 3; 108  27-ID Table 4B AA sequence of HC VR of Abs IDEVQLLESGGGLVKPGQSLKLSCAASGFTFTSYAMHWVRQPPGKGLEWVAVVSYDGNYKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 016, A017, C18, A019, 034, 040;SLRAEDTAVYYCAKDSRLRTLLYFEWLSQGYFDPWGQGTTLTVSSnon-ID version is in FIG. 2; 122  38-ID Table 4BAA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 187, 195; non-ID version is in EDVAVYYCQQHYRTPPSFGSGTKLDIKFIG. 3; 109 161-ID Table 4B AA sequence of HC VR consensus IDEVQLLESGGGLVKPGQSLKLSCAASGFTFSSYGMHWVRQPPGKGLEWVAVVSYDGSNKYYADSVQGRFTISRDNSKNTLYLQMNFIG. 13 ID; non-ID version is in FIG. SLRAEDTAVYYCAKDSKLRSLLYFEWLSSGLLDYWGQGAMVTVSS 2; 123  39-ID Table 4BAA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 188, 196; non-ID version is in EDVAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3; 124  40-ID Table 4B AA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 189, 197; non-ID version is in EDVAVYYCQQHYRTPPSFGNGTKLDIKFIG. 3; 125  41-ID Table 4B AA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 190, 198; non-ID version is in EDVAVYYCQQHYRTPPSFGTGTKLDIKFIG. 3; 126  42-ID Table 4B AA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 191, 199; non-ID version is in EDVAVYYCQQHYRTPPSFGSGTKLDIKFIG. 3; 127  43-ID Table 4B AA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 192, 200; non-ID version is in EDVAVYYCQQHYRTPPSFGQGTKLDIKFIG. 3; 128  44-ID Table 4B AA sequence of LC VR of Abs IDEIVMTQSPDSLAVSLGERATINCKSSQTLSFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 193; non-ID version is in FIG. EDVAVYYCQQHYRTPPSFGNGTKLDIK 3;129  47-ID Table 4B AA sequence of LC VR of Abs IDDIVMTQSPDTLAVTLGERATIQCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTITSLQAFIG. 14 A001, 004, 007, 016 EDVAVYYCQQHYRTPPSFGQGTKLDIK 130  48-IDTable 4B AA sequence of LC VR of Abs IDDIVMTQSPDTVAVTVGERATINCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 002, 005, 008, A017; non-ID  EDVAVYYCQQHYRTPPSFGQGTKLDIKversion is in FIG. 3; 131  49-ID Table 4B AA sequence of LC VR of Abs IDDIVMTQSPDTVAVTLGERATIDCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 A003, 006, A009, C18; non-ID  EDVAVYYCQQHYRTPPSFGQGTKLDIKversion is in FIG. 3; 132  50-ID Table 4B AA sequence of LC VR of Abs IDDIVMTQSPDTLAVTVGERATIRCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 A010 012, A14, A019; non-ID  EDVAVYYCQQHYRTPPSFGQGTKLDIKversion is in FIG. 3; 133  51-ID Table 4B AA sequence of LC VR of Ab IDDIVMTQSPDTLAVSRGERATIDCKSSQTVTFNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAFIG. 14 A011, 013, 015; non-ID version EDEAVYYCQQHYRTPPSFGQGTKLDIKis in FIG. 3; 134  52-ID Table 4B AA sequence of LC VR of Abs IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFDYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 044, 071, 072, 078; non-ID  EDFATYYCQQHYRTPPSFGQGTKVEIKversion is in FIG. 3; 135  53-ID Table 4BAA sequence of LC VR of Ab 051;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSTLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 136 54-ID Table 4B AA sequence of LC VR of Ab 049;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSHLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 137 55-ID Table 4B AA sequence of LC VR of Ab 047;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSKLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 138 56-ID Table 4B AA sequence of LC VR of Ab 050;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSDLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 139 57-ID Table 4B AA sequence of LC VR of Ab 045;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDVATYYCQQHYRTPPSFGQGTKVEIK 140 58-ID Table 4B AA sequence of LC VR of Ab 048;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDKATYYCQQHYRTPPSFGQGTKVEIK 141 59-ID Table 4B AA sequence of LC VR of Ab 046;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDDATYYCQQHYRTPPSFGQGTKVEIK 142 60-ID Table 4B AA sequence of LC VR of Ab 043;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQYYRTPPSFGQGTKVEIK 143 61-ID Table 4B AA sequence of LC VR of Ab 052;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSTRESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 157153-ID Table 4B AA sequence of LC VR of Ab 067;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFQYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 158154-ID Table 4B AA sequence of LC VR of Ab 068;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFRYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 159155-ID Table 4B AA sequence of LC VR of Abs IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFEYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 069, 079; non-ID version is in EDFATYYCQQHYRTPPSFGQGTKVEIKFIG. 3; 160 156-ID Table 4B AA sequence of LC VR of Ab 070;IDDIQMTQSPSSLSASVGDRVTITCRSSQSITFDYKNYLAWYQQKPGKAPKLLIYWGSTRESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 non-ID version is in FIG. 3; EDFATYYCQQHYRTPPSFGQGTKVEIK 144 62-ID Table 4B AA sequence of LC VR consensusIDDIQMTQSPSSLSASVGDRVTITCRSSQSITFNYKNYLAWYQQKPGKAPKLLIYWGSYLESGVPSRFSGSGSGTDFTLTISSLQPFIG. 14 ID; non-ID version is in FIG.  EDFATYYCQQHYRTPPSFGQGTKVEIK 3; 63VH16 Example 1 NT sequence of HC VR of Abs GAGGTACAGCTCCTCGAATCGGGAGGGGGACTGGTCAAACCCGGTCAATCGCTCAAACTCTCGTGTGCAGCGTCAGGTTTTACGTT014, 028CAGCTCATATGGGATGCACTGGGTCCGCCAGCCTCCGGGAAAGGGACTGGAGTGGGTGGCAGTCGTGTCGTATGACGGGAGCAATAAGTACTACGCCGATTCAGTGCAAGGTCGGTTTACCATTTCGAGGGATAACAGCAAGAACACGCTCTACTTGCAGATGAACTCACTTAGAGCGGAAGATACGGCTGTGTACTATTGCGCCAAAGACACAAAGCTGCGATCCCTGTTGTACTTCGAATGGTTGTCCTCGGGCTTGCTTGACTATTGGGGGCAGGGCGCCATGGTCACAGTATCCAGCGCGTCGACTAAGGGGCCC 64 VL29Example 1 NT sequence of LC VR of Abs GAGATCGTGATGACGCAGAGCCCCGATAGCCTCGCTGTCTCATTGGGGGAACGGGCCACGATTAACTGCAAATCCTCACAGTCGGT014, 154, 157GACTTTCAGCTATAAGAATTACCTGGCATGGTATCAGCAGAAGCCGGGTCAACCCCCAAAACTGTTGATCTACTGGGCCTCCACACGCGAGTCGGGAGTCCCGGACCGATTTTCGGGTTCAGGGTCCGGCACTGACTTTACCCTCACAATTTCATCGCTTCAAGCGGAGGATGTAGCAGTGTACTATTGTCAGCAGTATTACAGAACACCTCCCACCTTCGGAGGGGGAACGAAACTTGACATCAAGGGATCC65 VL30 Example 1 NT sequence of LC VR of Abs NT: GAGATCGTGATGACGCAGAGCCCCGATAGCCTCGCTGTCTCATTGGGGGAACGGGCCACGATTAACTGCAAATCCTCACAGT028, 155CGGTGACTTTCGACTATAAGAATTACCTGGCATGGTATCAGCAGAAGCCGGGTCAACCCCCAAAACTGTTGATCTACTGGGCCTCCACACGCGAGTCGGGAGTCCCGGACCGATTTTCGGGTTCAGGGTCCGGCACTGACTTTACCCTCACAATTTCATCGCTTCAAGCGGAGGATGTAGCAGTGTACTATTGTCAGCAGTATTACAGAACACCTCCCACCTTCGGAGGGGGAACGAAACTTGACATCAAGGGATCC66 VH15 Example 1 NT sequence of HC VR of Ab A18GAAGTGCAACTCCTCGAGTCAGGAGGAGGTTTGGTGAAACCGGGTCAGTCCTTGAAACTGAGCTGTGCAGCAAGCGGGTTCACGTTTACGTCGTACGGCATGCACTGGGTACGGCAGCCTCCCGGGAAGGGACTTGAATGGGTCGCCGTCATCTCATACGACGGGTCGTACAAATACTATGCGGATAGCGTGCAAGGTCGCTTCACAATTTCCCGGGACAATTCGAAGAATACACTGTATCTTCAGATGAACTCGCTCAGGGCTGAGGACACGGCGGTCTATTACTGCGCGAAGGATTCGCGACTCAGATCCCTTTTGTACTTTGAGTGGCTGTCGCAGGGGTATTTCAACCCATGGGGAGCCGGAACCACTTTGACCGTATCAAGCGCGTCAACAAAGGGGCCC 67 VL28Example 1 NT sequence of LC VR of Ab A18GAAATTGTAATGACGCAGAGCCCTGATAGCCTTGCCGTGTCCCTGGGTGAGAGGGCGACAATCAATTGTAAGTCATCACAGTCGGTCACGTACAACTACAAGAACTACCTGGCGTGGTATCAACAGAAACCCGGGCAGCCGCCCAAATTGCTCATCTATTGGGCTTCGACACGGGAGTCGGGTGTGCCAGACCGCTTCTCCGGGTCAGGATCGGGAACTGACTTCACGTTGACTATTTCGTCCCTCCAGGCAGAAGATGTAGCCGTCTACTATTGCCAACAGTATTACAGAACGCCGCCTACATTTGGAGGCGGGACCAAACTTGACATCAAGGGATCCGTGGCCGCCCCCAGCGTCTTCATCTTCCCGCCCAGCGACGAGCAGCTGAAGTCGGGCACGGCCAGCGTGGTGTGCCTCCTGAACAACTTCTACCCCCGCGAGGCGAAGGTCCAGTGGAAGGTGGACAACGCCCTGCAGAGCGGGAACAGCCAGGAGAGCGTGACCGAGCAGGACTCGAAGGACAGCACCTACAGCCTCAGCAGCACCCTGACGCTGAGCAAGGCCGACTACGAGAAGCACAAGGTCTACGCCTGCGAGGTGACCCACCAGGGGCTCTCGAGCCCCGTGACCAAGAGCTTCAACCGGGGCGAGTG 149 VL52 Example 1NT sequence of EC VR of Abs GACATTCAGATGACTCAGTCGCCTTCGTCATTGTCCGCCTCCGTGGGTGATAGGGTCACGATCACGTGCCGGAGCAGCCAGTCCAT044, 071, 072, 078CACCTTCAATTACAAAAACTATTTGGCATGGTATCAACAGAAACCCGGAAAGGCGCCGAAGCTCCTGATCTACTGGGGTTCATATCTTGAGTCGGGGGTGCCGTCGAGATTTTCGGGCAGCGGATCAGGGACGGATTTCACGCTGACCATTTCGTCACTCCAGCCCGAGGACTTTGCGACATATTACTGTCAACAGCACTACAGGACACCCCCATCTTTCGGACAGGGGACTAAAGTAGAAATCAAGGGATCCGTGGCCGCCCCCAGCGTCTTCATCTTCCCGCCCAGCGACGAGCAGCTGAAGTCGGGCACGGCCAGCGTGGTGTGCCTCCTGAACAACTTCTACCCCCGCGAGGCGAAGGTCCAGTGGAAGGTGGACAACGCCCTGCAGAGCGGGAACAGCCAGGAGAGCGTGACCGAGCAGGACTCGAAGGACAGCACCTACAGCCTCAGCAGCACCCTGACGCTGAGCAAGGCCGACTACGAGAAGCACAAGGTCTACGCCTGCGAGGTGACCCACCAGGGGCTCTCGAGCCCCGTGACCAAGAGCTTCAACCGGGGCGAGTGCTGA 150 VL45Example 1 NT sequence of LC VR of Abs GACATTCAGATGACTCAGTCGCCTTCGTCATTGTCCGCCTCCGTGGGTGATAGGGTCACGATCACGTGCCGGAGCAGCCAGTCCAT202, 203, 204, 210, 031, 032, CACCTTCAATTACAAAAACTATTTGGCATGGTATCAACAGAAACCCGGAAAGGCGCCGAAGCTCCTGATCTACTGGGGTTCATATC033, 034TTGAGTCGGGGGTGCCGTCGAGATTTTCGGGCAGCGGATCAGGGACGGATTTCACGCTGACCATTTCGTCACTCCAGCCCGAGGACTTTGCGACATATTACTGTCAACAGCACTACAGGACACCCCCATCTTTCGGACAGGGGACTAAAGTAGAAATCAAGGGATCCGTGGCCGCCCCCAGCGTCTTCATCTTCCCGCCCAGCGACGAGCAGCTGAAGTCGGGCACGGCCAGCGTGGTGTGCCTCCTGAACAACTTCTACCCCCGCGAGGCGAAGGTCCAGTGGAAGGTGGACAACGCCCTGCAGAGCGGGAACAGCCAGGAGAGCGTGACCGAGCAGGACTCGAAGGACAGCACCTACAGCCTCAGCAGCACCCTGACGCTGAGCAAGGCCGACTACGAGAAGCACAAGGTCTACGCCTGCGAGGTGACCCACCAGGGGCTCTCGAGCCCCGTGACCAAGAGCTTCAACCGGGGCGAGTGCTGAGAATTC 151 VH25Example 1 NT sequence of HC VR of Abs CAGGTACAATTGCTTGAGACAGGTGGAGGACTCGTGAAGCCAGGTCAGTCATTGAAACTGAGCTGTGCCGCATCCGGGTTCACATT004, 005, 006, 012, 013, 032,CACTTCCTACGCGATGCACTGGGTCCGCCAGCCTCCCGGAAAGGGACTTGAGTGGGTCGCTGTGGTATCGTATGATGGGAATTACA038, 043, 044, 045, 046, 047,AATACTATGCAGACTCCGTGCAAGGCCGGTTTACGATTAGCAGGGACAACTCGAAGAATACCCTTTACCTCCAAATGAACTCGCTC048, 049, 050, 051, 052, 067,CGAGCGGAGGACACGGCGGTGTATTACTGCGCGAAGGATTCACGGTTGAGATCGCTGCTCTATTTTGAATGGTTGTCACAGGGGTA068, 069, 070, 073, 074, 075,CTTCAACCCGTGGGGTCAGGGAACAACACTGACCGTCAGCTCAGCCTCGACTAAAGGGCCCAGCGTGTTCCCGCTGGCCCCCAGCA076, 077GCAAGAGCACCAGCGGCGGGACCGCCGCCCTGGGCTGCCTCGTCAAGGACTACTTCCCCGAGCCCGTGACCGTGTCGTGGAACAGCGGCGCGCTGACGAGCGGGGTCCACACCTTCCCGGCCGTGCTGCAGAGCAGCGGCCTCTACTCGCTGAGCAGCGTGGTCACCGTGCCCAGCAGCAGCCTGGGGACCCAGACGTACATCTGCAACGTGAACCACAAGCCCTCGAACACCAAGGTCGACAAGAAGGTGGAGCCCCCGAAGAGCTGCGACAAAACTCACACATGCCCACCGTGCCCAGGTACTGAACTCCTGGGGGGACCGTCAGTCTTCCTCTTCCCCCCAAAACCCAAGGACACCCTCATGATCTCCCGGACCCCTGAGGTCACATGCGTGGTGGTGGACGTGAGCCACGAAGACCCTGAGGTCAAGTTCAACTGGTACGTGGACGGCGTGGAGGTGCATAATGCCAAGACAAAGCCGCGGGAGGAGCAGTACAACAGCACGTACCGTGTGGTCAGCGTCCTCACCGTCCTGCACCAGGACTGGCTGAATGGCAAGGAGTACAAGTGCAAGGTCTCCAACAAAGCCCTCCCAGCCCCCATCGAGAAAACCATCTCCAAAGCCAAAGGTGAGCCCCGAGAACCACAGGTGTACACCCTGCCCCCATCCCGGGATGAGCTGACCAAGAACCAGGTCAGCCTGACCTGCCTGGTCAAAGGCTTCTATCCCAGCGACATCGCCGTGGAGTGGGAGAGCAATGGGCAGCCGGAGAACAACTACAAGACCACGCCTCCCGTGCTGGACTCCGACGGCTCCTTCTTCCTCTACAGCAAGCTCACCGTGGACAAGAGCAGGTGGCAGCAGGGGAACGTCTTCTCATGCTCCGTGATGCATGAGGCTCTGCACAACCACTACACGCAGAAGAGCCTCTCCCTGTCTCCGGGTAAATGA 152 VH24 Example 1 NT sequence of HC VR of Abs GAAGTACAATTGCTTGAGTCGGGTGGAGGACTCGTGAAGCCAGGTCAGTCATTGAAACTGAGCTGTGCCGCATCCGGGTTCACATTA001, A002, A003, A010, A011, CACTTCCTACGCGATGCACTGGGTCCGCCAGCCTCCCGGAAAGGGACTTGAGTGGGTCGCTGTGGTATCGTATGATGGGAATTACA031, 037AATACTATGCAGACTCCGTGCAAGGCCGGTTTACGATTAGCAGGGACAACTCGAAGAATACCCTTTACCTCCAAATGAACTCGCTCCGAGCGGAGGACACGGCGGTGTATTACTGCGCGAAGGATTCACGGTTGAGATCGCTGCTCTATTTTGAATGGTTGTCACAGGGGTACTTCAACCCGTGGGGTCAGGGAACAACACTGACCGTCAGCTCAGCCTCGACTAAAGGGCCCAGCGTGTTCCCGCTGGCCCCCAGCAGCAAGAGCACCAGCGGCGGGACCGCCGCCCTGGGCTGCCTCGTCAAGGACTACTTCCCCGAGCCCGTGACCGTGTCGTGGAACAGCGGCGCGCTGACGAGCGGGGTCCACACCTTCCCGGCCGTGCTGCAGAGCAGCGGCCTCTACTCGCTGAGCAGCGTGGTCACCGTGCCCAGCAGCAGCCTGGGGACCCAGACGTACATCTGCAACGTGAACCACAAGCCCTCGAACACCAAGGTCGACAAGAAGGTGGAGCCCCCGAAGAGCTGCGACGGTACCCACACATGCCCACCGTGCCCAGGTACTGAACTCCTGGGGGGACCGTCAGTCTTCCTCTTCCCCCCAAAACCCAAGGACACCCTCATGATCTCCCGGACCCCTGAGGTCACATGCGTGGTGGTGGACGTGAGCCACGAAGACCCTGAGGTCAAGTTCAACTGGTACGTGGACGGCGTGGAGGTGCATAATGCCAAGACAAAGCCGCGGGAGGAGCAGTACAACAGCACGTACCGTGTGGTCAGCGTCCTCACCGTCCTGCACCAGGACTGGCTGAATGGCAAGGAGTACAAGTGCAAGGTCTCCAACAAAGCCCTCCCAGCCCCCATCGAGAAAACCATCTCCAAAGCCAAAGGTGAGCCCCGAGAACCACAGGTGTACACCCTGCCCCCATCCCGGGATGAGCTGACCAAGAACCAGGTCAGCCTGACCTGCCTGGTCAAAGGCTTCTATCCCAGCGACATCGCCGTGGAGTGGGAGAGCAATGGGCAGCCGGAGAACAACTACAAGACCACGCCTCCCGTGCTGGACTCCGACGGCTCCTTCTTCCTCTACAGCAAGCTCACCGTGGACAAGAGCAGGTGGCAGCAGGGGAACGTCTTCTCATGCTCCGTGATGCATGAGGCTCTGCACAACCACTACACGCAGAAGAGCCTCTCCCTGTCTCCGGGTAAATGA 94 15 FIG. 1 AA sequence of HC of Ab A18EVQLLESGGGLVKPGQSLKLSCAASGFTFTSYGMHWVRQPPGKGLEWVAVISYDGSYKYYADSVQGRFTISRDNSKNTLYLQMNSLRAEDTAVYYCAKDSRLRSLLYFEWLSQGYFNPWGAGTTLTVSSASTKGPSVFPLAPSSKSTSGGTAALGCLVKDYFPEPVTVSWNSGALTSGVHTFPAVLQSSGLYSLSSVVTVPSSSLGTQTYICNVNHKPSNTKVDKKVEPPKSCDKTHTCPPCPGTELLGGPSVFLFPPKPKDTLMISRTPEVTCVVVDVSHEDPEVKFNWYVDGVEVHNAKTKPREEQYNSTYRVVSVLTVLHQDWLNGKEYKCKVSNKALPAPIEKTISKAKGEPREPQVYTLPPSRDELTKNQVSLTCLVKGFYPSDIAVEWESNGQPENNYKTTPPVLDSDGSFFLYSKLTVDKSRWQQGNVFSCSVMHEALHNHYTQKSLSLSPGK 95 28 FIG. 1 AA sequence of LC of Ab A18EIVMTQSPDSLAVSLGERATINCKSSQSVTYNYKNYLAWYQQKPGQPPKLLIYWASTRESGVPDRFSGSGSGTDFTLTISSLQAEDVAVYYCQQYYRTPPTFGGGTKLDIKGSVAAPSVFIFPPSDEQLKSGTASVVCLLNNFYPREAKVQWKVDNALQSGNSQESVTEQDSKDSTYSLSSTLTLSKADYEKHKVYACEVTHQGLSSPVTKSFNRGE 145 n.a. see textAA sequence of LC CDR1 of Ab  QSITFDYKNYLA 044 146 n.a. see textAA sequence of LC CDR1 of FI6 KSSQSVTFNYKNYLA VK 147 n.a. see textAA sequence of LC CDR2 of FI6 WASARES VK 148 n.a. see textAA sequence of LC CDR3 of FI6 QQHYRTPPT VK 68 n.a. see textAA sequence of HC CDR1 of Abs  SYAMH 044, 069, 032, 031 69 n.a. see textAA sequence of HC CDR2 of Abs  VVSYDGNYKYYADSVQG 044, 069, 032, 031 70n.a. see text AA sequence of HC CDR3 of Abs  DSRLRSLLYFEWLSQGYFNP044, 069, 032, 031 71 n.a. see text AA sequence of LC CDR1 of Abs QSITFNYKNYLA 032, 031 72 n.a. see text AA sequence of LC CDR2 of Abs WGSYLES 044, 069, 032, 031 73 n.a. see textAA sequence of LC CDR3 of Abs  QQHYRTPPS 044, 069, 032, 031 74 n.a.see text AA sequence of HC FR1 of Ab 069 QVQLLETGGGLVKPGQSLKLSCAASGFTFT75 n.a. see text AA sequence of HC FR2 of Ab 069 WVRQPPGKGLEWVA 76 n.a.see text AA sequence of HC FR3 of Ab 069RFTISRDNSKNTLYLQMNSLRAEDTAVYYCAK 77 n.a. see textAA sequence of HC FR4 of Ab 069 WGQGTTLTVSS 78 n.a. see textAA sequence of LC FR1 of Ab 069 DIQMTQSPSSLSASVGDRVTITCRSS 79 n.a.see text AA sequence of LC FR2 of Ab 069 WYQQKPGKAPKLLIY 80 n.a.see text AA sequence of LC FR3 of Ab 069GVPSRFSGSGSGTDFTLTISSLQPEDFATYYC 81 n.a. see textAA sequence of LC FR4 of Ab 069 FGQGTKVEIK 82 n.a. see textAA sequence of HC FR1 of Ab 031 EVQLLESGGGLVKPGQSLKLSCAASGFTFT 83 n.a.see text AA sequence of LC CDR1 of Ab  KSSQSVTYNYKNYLA A18 et al. 84n.a. see text AA sequence of LC CDR2 of Ab  WASTRES A18 et al. 85 n.a.see text AA sequence of LC CDR3 of Ab  QQYYRTPPT A18 et al. 86 n.a.see text AA sequence of HC CDR1 of Ab  SYGMH A18 et al. 87 n.a. see textAA sequence of HC CDR2 of Ab  VISYDGSYKYYADSVQG A18 et al. 88 n.a.see text AA sequence of an HC CDR3 DSELRSLLYFEWLSQGYFNP 89 n.a. see textAA sequence of HC FR4 of Ab A18  WGAGTTLTVSS et al. 90 n.a. see textAA sequence of LC FR1 of Ab A18  EIVMTQSPDSLAVSLGERATINC et al. 91 n.a.see text AA sequence of LC FR2 of Ab A18 WYQQKPGQPPKLLIY et al. 92 n.a.see text AA sequence of LC FR3 of Ab A18GVPDRFSGSGSGTDFTLTISSLQAEDVAVYYC et al. 93 n.a. see textAA sequence of LC FR4 of Ab A18 FGGGTKLDIK et al. 171 n.a. see textAA sequence of HC FR4 of Ab 078 WGQGTTVTVSS et al 172 n.a. see textAA sequence of LC CDR1 of Ab  QSITFEYKNYLA 069 173 n.a. see textAA sequence of H3 HA1QDLPGNDNSTATLCLGHHAVPNGTLVKTITDDQIEVTNATELVQSSSTGKICNNPHRILDGIDCTLIDALLGDPHCDVFQNETWDLFVERSKAFSNCYPYDVPDYASLRSLVASSGTLEFITEGFTWTGVTQNGGSNACKRGPGSGFFSRLNWLTKSGSTYPVLNVTMPNNDNFDKLYIWGIHHPSTNQEQTSLYVQASGRVTVSTRRSQQTIIPNIGSRPWVRGLSSRISIYWTIVKPGDVLVINSNGNLIAPRGYFKMRTGKSSIMRSDAPIDTCISECITPNGSIPNDKPFQNVNKITYGACPKYVKQNTLKLATGMRNVPEKQTR174 n.a. see text AA sequence of H3 HA2GLFGAIAGFIENGWEGMIDGWYGFRHQNSEGTGQAADLKSTQAAIDQINGKLNRVIEKTNEKFHQIEKEFSEVEGRIQDLEKYVEDTKIDLWSYNAELLVALENQHTIDLTDSEMNKLFEKTRRQLRENAEEMGNGCFKIYHKCDNACIESIRNGTYDHDVYRDEALNNRFQIKG 175 n.a. FIG. 12 AA sequence of HC VR of FI6QVQLVQSGGGVVQPGRSLRLSCVASGFTFSTYAMHWVRQAPGRGLEWVAVISYDGNYKYYADSVKGRFSISRDNSNNTLHLEMNTLRTEDTALYYCAKDSQLRSLLYFEWLSQGYFDPWGQGTLVTVTS 176 n.a. FIG. 12AA sequence of HC VR of FI370QVQLVQSGGGVVPPGRSLRLSCAASGFTFSTYGMHWVRQAPGKGLEWVAVISYDGNYKYYADSVRGRFTISRDNSKNTLNLDMNSLRTEDTALYYCAKDSQLRSLLYFDWLSQGYFDHWGQGTLVTVSS 177 n.a. FIG. 12AA sequence of HC VR of FI6 QVQLVESGGGVVQPGRSLRLSCAASGFTFSSYGMHWVRQAPGKGLEWVAVISYDGSNKYYADSVKGRFTISRDNSKNTLYLQMNSLvariant 1 RAEDTAVYYCAKDSQLRSLLYFDWLSQGYFDYWGQGTLVTVSS 178 n.a. FIG. 12AA sequence of HC VR of FI6 QVQLVESGGGVVQPGRSLRLSCAASGFTFSTYAMHWVRQAPGKGLEWVAVISYDANYKYYADSVKGRFTISRDNSKNTLYLQMNSLvariant 3 RAEDTAVYYCAKDSQLRSLLYFEWLSQGYFDYWGQGTLVTVSS 179 n.a. FIG. 12AA sequence of HC VR of FI6/370QVQLVQSGGGVVQPGRSLRLSCAASGFTFSTYGMHWVRQAPGKGLEWVAVISYDGNYKYYADSVKGRFTISRDNSKNTLYLEMNSLRTEDTALYYCAKDSQLRSLLYFDWLSQGYFDHWGQGTLVTVSS 180 n.a. FIG. 12AA sequence of kappa LC VR of DIQMTSQPDSLAVSLGARATINCKSSQSVTFNYKNYLAWYQQKPGQPPKVLIYWASARESGVPDRFSGSGSGTDFTLTISSLQAEDFI6 VAVYYCQQHYRTPPTFGQGTKVEIK 181 See text AA sequence of H1 HA1TNADTICIGYHANNSTDTVDTVLEKNVTVTHSVNLLEDSHNGKLCKLKGIAPLQLGKCNIAGWLLGNPECDLLLTASSWSYIVETSNSENGTCYPGDFIDYEELREQLSSVSSFEKFEIFPKTSSWPNHETTKGVTAACSYAGASSFYRNLLWLTKKGSSYPKLSKSYVNNKGKEVLVLWGVHHPPTGTDQQSLYQNADAYVSVGSSKYNRRFTPEIAARPKVRDQAGRMNYYWTLLEPGDTITFEATGNLIAPWYAFALNRGSGSGIITSDAPVHDCNTKCQTPHGAINSSLPFQNIHPVTIGECPKYVRSTKLRMATGLRNIPSIQS182 See text AA sequence of H1 HA2GLFGAIAGFIEGGWTGMIDGWYGYHHQNEQGSGYAADQKSTQNAIDGITNKVNSVIEKMNTQFTAVGKEFNNLERRIENLNKKVDDGFLDIWTYNAELLVLLENERTLDFHDSNVRNLYEKVKSQLKNNAKEIGNGCFEFYHKCDDACMESVRNGTYDYPKYSEESKLNREEIDGVKLESMGVYQILAIYSTVASSLVLLVSLGAISFWMCSNGSLQCRICI

EXAMPLES Example 1: Safety and Upper Respiratory Pharmacokinetics of theHemagglutinin Antibody VIS410 Support Treatment and Prophylaxis Based onPopulation Modeling of Seasonal Influenza A Outbreaks Summary

Background.

Seasonal influenza is a major public health concern in vulnerablepopulations. Monoclonal antibody therapies represent a modality fortreatment and prophylaxis given their safe profile and broadneutralizing ability.

Methods.

Using a single-ascending dose study (n=41) at dose levels from 2mg/kg-50 mg/kg, the safety and pharmacokinetics (e.g., serum and upperrespiratory pharmacokinetics) of a broadly-neutralizing antibody(VIS410, also known as Ab 044 herein) against influenza A werecharacterized (ClinicalTrials.gov identifier NCT02045472). The primaryendpoints were safety and tolerability of VIS410 compared to placebo. Anepidemic microsimulation model was developed for testing the ability ofVIS410 to mitigate attack rates and severe disease in atrisk-populations.

Findings.

VIS410 was found to be generally safe and well-tolerated at all doselevels, from 2-50 mg/kg. Overall, 27 of 41 subjects (65.9%) reported atotal of 67 treatment emergent adverse events (TEAEs). TEAEs werereported by 20 of 30 subjects (66.7%) who received VIS410 and by 7 of 11subjects (63.6%) who received placebo. 14 of 16 TEAEs related to studydrug were considered mild (Grade 1) and 2 were moderate (Grade 2). Twosubjects (1 subject who received 30 mg/kg VIS410 and 1 subject whoreceived placebo) experienced serious AEs (grade 3 or 4 TEAEs) that werenot related to study drug. VIS410 exposure was approximatelydose-proportional with a mean half-life of 12.9 days. Mean VIS410C_(max) levels in the upper respiratory tract were 20.0 and 25.3 μg/mlat the 30 mg/kg and 50 mg/kg doses, respectively, with correspondingserum C_(max) levels of 980.5 and 1316 μg/mL. Using thesepharmacokinetic data, the microsimulation model showed that medianattack rate reductions ranged from 8.6% (interquartile range (IQR):4.7%-11.0%) for 2% coverage to 22.6% (IQR: 12.7-30.0%) for 6% coverage.The overall benefits to the elderly, a vulnerable subgroup, are largestwhen VIS410 is distributed exclusively to elderly individuals, resultingin reductions in hospitalization rates between 11.4% (IQR: 8.2%-13.3%)for 2% coverage and 30.9% (IQR: 24.8%-35.1%) for 6% coverage among thosemore than 65 years of age.

Interpretation.

VIS410 was generally safe and well tolerated and had good relativeexposure in both serum and upper respiratory tract, supporting its useas either a single-dose therapeutic or prophylactic for influenza A.Including VIS410 prophylaxis among the public health interventions forseasonal influenza can be used to lower attack rates and substantiallyreduce hospitalizations in individuals over the age of 65.

To summarize, in this Example, the safety, tolerability, andpharmacokinetics of a broadly neutralizing, stalk-binding monoclonalantibody (VIS410) against Influenza A were investigated in a Phase 1clinical trial. Based on these results and preclinical data, amathematical modeling approach was used to investigate whether VIS410could be used prophylactically to lessen the burden of a seasonalinfluenza epidemic and to protect at-risk groups from associatedcomplications.

VIS410 is a broadly neutralizing monoclonal antibody that was engineeredto bind a conserved region on the influenza A hemagglutinin protein thatis used by the virus to bind and enter infected cells. VIS410 has adirect mechanism of action, inhibiting HA-mediated cell fusion,neutralizing the virus and preventing cell infection. For a drug to bean effective prophylactic against seasonal influenza it should have astrong neutralizing effect against both group 1 viruses, such as H1N1,and group 2 viruses, such as H3N2, target an epitope that is conservedand widely shared among influenza subtypes, have a PK/PD profile thataffords sufficient protection for a typical flu season, and have a goodsafety profile. The pre-clinical and phase 1 clinical data demonstratesthat VIS410 possesses these properties. It was shown that VIS410 is safeand well tolerated in a phase 1 clinical trial in healthy adultvolunteers who were given a single infusion of the drug. Measurements ofthe drug levels of VIS410 in the upper respiratory tract demonstratedthat protective levels were achieved at the site of influenza infection.Given the phase 1 trial results, Epidemic modeling analyses indicatethat for a sufficiently potent and long-lasting antibody, such asVIS410, that prophylactic administration to 4-6% of the population,focused on high risk individuals (e.g., elderly individuals), would besufficient to lower (e.g., substantially suppress overall)hospitalizations related to severe influenza. Seasonal influenza Ainfection results in significant morbidity and mortality especially inhigh risk groups such as the elderly. Notably, given the currentstate-of-the-art in the production of antibodies, it is possible torapidly ensure availability of adequate supply of monoclonal antibody toprotect such a population during an influenza season in a much shortertime scale than that for production of a vaccine, incorporating novelstrains (generally >6 months).

Introduction

Severe influenza occurs each winter especially in high-risk groups suchas young children, older adults, patients with pulmonary conditions,inflammatory conditions, malignancies, and pregnant women (Newton et al.The American journal of managed care 2000; 6(5 Suppl): S265-75; Schanzeret al. Vaccine 2008; 26(36): 4697-703). Despite available therapy withneuraminidase inhibitors, including oseltamivir, zanamivir, andperamivir; 10%-44% of hospitalized patients require intensive care and25%-50% of these patients die. In the United States, it is estimatedthat as many as to 400,000 patients are hospitalized with influenza eachyear, with as many as 50,000 deaths per year (Centers for DiseaseControl U.; Hamborsky et al., editors. Epidemiology and Prevention ofVaccine-Preventable Diseases. 13th ed. Washington, D.C.: Public HealthFoundation; 2015). Furthermore, as evidenced by pandemic influenza Ainfections such as the 2009 “swine flu” pandemic, newly emerginginfluenza subtypes represent a considerable threat to global publichealth as they have the potential to cause significant morbidity andmortality.

The majority of the severe disease burden during seasonal influenza isexperienced by individuals over the age of 65, who are susceptible to anumber of complications following infection with influenza virus (Reedet al. PloS one 2015; 10(3): e0118369; Thompson et al. Jama 2004;292(11): 1333-40). Currently available public health interventions havenot significantly mitigated disease burden for the elderly. Vaccinationwith trivalent or tetravalent killed influenza has historically hadlower measured efficacy in elderly individuals compared to adults andchildren (Darvishian et al. The Lancet Infectious diseases 2014; 14(12):1228-39; Breteler Vaccine 2013; 31(45): 5168-77; Osterholm The LancetInfectious diseases 2012; 12(1): 36-44). Prophylaxis or early treatmentwith neuraminidase inhibitors are the current de facto standard of carehowever, some controversy exists as to whether a direct link can beestablished between early oseltamivir treatment and lowerhospitalization rates (Jefferson et al. Bmj 2014; 348: g2545). Based onthese shortfalls in care, there is a need to develop countermeasures toreduce or mitigate the effects of influenza in the elderly and othersusceptible populations.

The benefits of broadly neutralizing antibodies are that they canprotect elderly individuals from influenza infection regardless ofimmune response and potentially provide a reliable option whenconsidering the vaccine mismatches that occur against influenza everythree to five years. Using an antibody engineering approach, a broadlyneutralizing antibody (VIS410) that targets a unique, conserved epitopeon influenza hemagglutinin and binds to and neutralizes influenza Avirus across group 1 and group 2 subtypes was developed. In vitro,VIS410 has been shown to neutralize groups 1 and 2 influenza strains;over 40 different virus strains have been tested to date, with EC₅₀values ranging from 0.1-˜60 μg/mL and representing broadtemporal/geographical, subtype, and epitope diversity (Tharakaraman etal. Proc Natl Acad Sci USA. 2015; 112(35):10890-5; Baranovich et al.Antimicrob Agents Chemother. 2016; pii: AAC.02457-15). Additionally, invivo studies in mouse models demonstrated that VIS410 administered as aprophylactic or therapeutic protects mice challenged with lethal dosesof influenza A, including A/Puerto Rico/8/1934 [H1N1],A/California/04/2009 [H1N1], A/Victoria/3/1975 [H3N2], andA/Vietnam/1203/2004 [H5N1]. VIS410 also demonstrated protection againstnewly emerging pathogenic H7N9 strains, A/Anhui/1/2013 andoseltamivir-resistant A/Shanghai/1/2013 in a lethal BALB/c mouse model(Baranovich et al. Antimicrob Agents Chemother. 2016; pii:AAC.02457-15). VIS410 is being developed as a single dose treatment forhospitalized patients with influenza A is currently in phase 2 studies.

Described herein are the safety and pharmacokinetics of VIS410 in theserum and the upper respiratory tract, the primary target organ ofinfection of influenza A. Furthermore, this information was utilized tomodel the application of a broadly neutralizing antibody, such asVIS410, during an influenza outbreak to mitigate severe disease,especially for at risk-populations. Evidence has been provided thatVIS410 is generally safe and well-tolerated in healthy subjects withprotective levels of antibody achieved in the upper respiratory tract,and that it has a pharmacokinetic/pharmacodynamic (PK/PD) profile thatmay allow it to be used as a prophylactic during or prior to a period ofhigh influenza activity. Taken together, these data support thedevelopment of a broadly neutralizing monoclonal antibody as a strategyfor reducing the severity of seasonal influenza.

Methods

Production of Antibody.

VIS410 was produced under current Good Manufacturing Practice (cGMP) atGallus Biopharmaceuticals (Princeton, N.J.) in a CHO cell line. Afterproduction at a 200 L scale, VIS410 was purified by protein A and ionexchange polishing steps. Testing of bulk drug substance indicated thatthe material was >99% monomer, containing <0.1 μg/mg residual DNA and<0.1 ng/mg of host cell proteins. VIS410 materials were formulated at 25mg/mL in in 40 mM Citrate-Sodium Phosphate, 150 mM NaCl, pH 6.0,containing 0.025% Tween-80.

Phase I Clinical Trial.

A Phase 1, double-blind, placebo-controlled, single ascendingdose-escalation study was completed in healthy adult subjects(ClinicalTrials.gov identifier NCT02045472). This study was conductedaccording to the International Conference on Harmonisation harmonisedtripartite guideline E6(R1): Good Clinical Practice. InstitutionalResearch Board approval for the study was obtained in writing before thestudy began. The primary endpoint for the study was the safety andtolerability of VIS410 compared to placebo and the secondary endpointwas the serum pharmacokinetics of a single dose of VIS410. Eligiblesubjects were admitted to the clinic for dose administration and weredischarged 24-hours post-infusion. Overall, 30 subjects were dosed withVIS410 and 11 subjects were dosed with a placebo control infusion. Ninesubjects were dosed in the first cohort (Cohort 1); 6 subjects receivedVIS410 (2 mg/kg) and 3 subjects received placebo (sodium chloride 0.9%).Eight subjects were dosed in the subsequent cohorts (Cohorts 2 through5) and were randomly assigned in a 6:2 ratio to receive either VIS410 orplacebo. The detailed phase 1 protocol is also presented herein.

Briefly, in the first cohort (Cohort 1) the first four sentinel subjectswere randomly assigned to receive either VIS410 (2 mg/kg; n=2) orplacebo (n=2) and received study drug at least 48 hours before theremaining subjects in the cohort were dosed. After the investigator hadassessed that the infusions were well tolerated, the remaining subjectsin the cohort were dosed concurrently (VIS410 n=4 and placebo n=1). Ineach subsequent cohort, the first 3 subjects were randomly assigned toreceive either VIS410 (n=2) or placebo (n=1) and received study drug atleast 48 hours before the remaining subjects in the cohort were dosed.After the investigator had assessed that the infusions were welltolerated, the remaining members of the cohort (VIS410 n=4 and placebon=1) were dosed concurrently. Dose escalation to the next dosing leveloccurred after the Safety Monitoring Committee (SMC) comprised of theinvestigator, an independent medical monitor, and the sponsor reviewedthe safety data through Day 7 after the infusion.

Assessment of safety by the SMC was determined from vital signmeasurements; physical examinations; hematology, chemistry, andurinalysis laboratory testing; 12-lead triplicate electrocardiograms(ECGs); use of concomitant medications; and review of adverse events(AEs). Blood samples for pharmacokinetic (PK) analysis and forassessment of antidrug antibodies (ADA) to VIS410 were obtained beforeand after the infusion during the 120-day study period (Days 1, 2, 3, 7,14±1, 28±3, 56±7, and 120±7). Nasopharyngeal (NP) swabs, to assess upperrespiratory VIS410 concentrations, were collected before and after theinfusion from subjects in the 15, 30, and 50 mg/kg cohorts (Days 1, 3and 7).

Pharmacokinetic and Antidrug Antibody Assays.

Blood samples were collected at the time points described herein. Serumwas aliquoted and stored at −20° C. to −80° C. All samples were testedfor IgG antibody concentrations using an enzyme-linked immunosorbentassay. Nasopharyngeal swabs (one from each nostril) for the analysis ofthe local concentration of VIS410 were taken using COPAN flocked swabsfrom subjects in the 15, 30, and 50 mg/kg cohorts at the time pointsdescribed herein. The swabs from each nostril were combined in 1transport tube containing 3 mL COPAN Universal Transport Medium andstored at −70° C. Samples were tested for VIS410 by an immunoassay. Thesamples for ADA analysis were collected in serum separator tubes. Serumwas aliquoted and stored at −20° C. to −80° C. The enzyme-linkedimmunosorbent assay was performed. Descriptive statistics were used tosummarize data between groups. Statistical comparisons of the frequencyof adverse events for placebo versus VIS410 receiving subjects usedFisher's exact test. All statistical analyses were conducted using SAS®software Version 9.3 (SAS Institute, Inc, Cary, N.C.), and the PKanalysis was conducted using Phoenix WinNonlin® Version 6.2.1 (PharsightCorporation, St Louis, Mo.).

Individual-Based Population Model.

An individual-based microsimulation was developed based on a previouslydeveloped model, and is similar in structure and design to an array ofmicrosimulation models that have been developed over the past decade(Boni et al. Philosophical transactions of the Royal Society of LondonSeries B, Biological sciences 2013; 368(1614): 20120207; Ferguson et al.Nature 2005; 437(7056): 209-14; Germann et al. Proceedings of theNational Academy of Sciences of the United States of America 2006;103(15): 5935-40; Longini et al. Science 2005; 309(5737): 1083-7).Individual-based microsimulation methods were used to test thepopulation-level effects of deploying VIS410 during a typical winterinfluenza epidemic and to perform sensitivity analyses on key unknownparameters.

Briefly, the model simulates an age-structured population of one millionindividuals living in a city with 100 pre-defined neighborhoods orlocations. Daily work commutes, random within-city travel, householdstructure, pre-existing immunity, and age-based social contacts areincluded in the model. Influenza infection and potential hospitalizationare modeled by randomly infecting individuals by location or household,in proportion to the current level of infections and contacts in thatlocation or household. Infection, seasonality, contact structure,hospitalization, and the clinical course and epidemiology of influenzain the model were validated using characteristics of past influenzaepidemics of influenza A, as described herein.

In the microsimulation, VIS410 was deployed as a population-wideprophylaxis strategy. A small percentage of individuals received VIS410prophylaxis (between 0% and 6%) in the early stages of the epidemic, andtwo modes of distribution were included: randomly to all individuals orrandomly to only elderly individuals (>65 years old). The distributiontime was varied between eight weeks prior to the epidemic peak and thedate of the modelled epidemic peak. VIS410 levels in individuals weremodeled using an exponential decay function, with a half-life of 13days. VIS410 was modeled to be administered at a level that was 8-foldover a minimally protective dose of approximately 1-2 mg/kg based onpreclinical estimates, corresponding to over 3 half-lives of protection.Levels of VIS410 over the protective threshold confer a 90% reduction inthe probability of being infected, with the protection decreasingexponentially as a function of VIS410 levels below the minimallyprotective threshold. Levels of VIS410 below 0.1-fold of the protectivethreshold were considered to be non-protective. This behavior is shownin FIG. 4.

Results

VIS410 is an engineered human IgG1 antibody that targets a unique,conserved conformational epitope on the stem of Influenza A virus HAprotein. Previous studies have identified that VIS410 has broadreactivity against both group 1 and group 2 influenza A. Abioinformatics analysis of over 26,500 H1N1 and H3N2 HA sequencesdemonstrates the conserved nature of the targeted epitope within H1 andH3 subgroups (Tharakaraman et al. Proc Natl Acad Sci USA. 2015;112(35):10890-5). FIG. 8 shows the observed residue composition of thisepitope based on a sequence analysis of currently circulating strains(collected since 2012), supporting the pre-clinical in vitro and in vivoanalyses which indicates that VIS410 is effective against a broad panelof seasonal H1 and H3 influenza viruses as well as H7N9 virus.

A Phase 1, placebo-controlled, single ascending dose study of VIS410 inhealthy volunteers was initiated at a single site in North America. Fivecohorts were dosed with levels ranging from 2 to 50 mg/kg (Table 5). Atotal of 41 subjects were enrolled in the phase 1 study. Overall, 36subjects (87.8%) completed the study and 5 subjects (12.2%) discontinuedearly. All 41 subjects (100.0%) who received study drug (VIS410 orplacebo) were included in the safety analysis set. All 30 subjects(100.0%) who received a dose of VIS410 and had at least one evaluable PKparameter were included in the PK analysis set. Five subjects (12.2%)withdrew consent (4 of 30 subjects [13.3%] who received VIS410 and 1 of11 subject [9.1%] who received placebo). For 1 subject (Subject 402; 30mg/kg VIS410), the investigator was unblinded to the subject's treatmentdue to serious adverse events (SAEs) of leukopenia and herpes simplexesophagitis. This SAE was ultimately found to be unrelated to the studydrug as a primary herpes simplex virus type 1 infection was confirmedbased on analysis of pre and post event serology.

TABLE 5 Summary of Subject Disposition VIS410 2 5 15 30 50 mg/kg mg/kgmg/kg mg/kg mg/kg Total Placebo Overall (n = 6) (n = 6) (n = 6) (n = 6)(n = 6) (N = 30) (N = 11) (N = 41) Total number of subjects, No. (%)Completed 6 4 5 5 6 26 10 36 (100.0) (66.7) (83.3) (83.3) (100.0) (86.7)(90.9) (87.8) Discontinued 0 2 1 1 0 4 1 5 (33.3) (16.7) (16.7) (13.3)(9.1) (12.2) Primary reason for discontinuation, No. (%) Subjectwithdrew 0 2 1 1 0 4 1 5 consent (33.3) (16.7) (16.7) (13.3) (9.1)(12.2) Study Population, No. (%) Safety analysis set^(a) 6 6 6 6 6 30 1141 (100.0) (100.0) (100.0) (100.0) (100.0) (100.0) (100.0) (100.0)Pharmacokinetic 6 6 6 6 6 30 0 30 analysis set^(b) (100.0) (100.0)(100.0) (100.0) (100.0) (100.0) (73.2) Note: Percentages were based onthe number of subjects within each group and overall. ^(a)The safetyanalysis set included all subjects who received a dose of VIS410 orplacebo. ^(b)The pharmacokinetic analysis set included all subjects whoreceived a dose of VIS410 and had at least 1 evaluable pharmacokineticparameter.

Safety Results.

Overall, 27 of 41 subjects (65.9%) reported a total of 67 treatmentemergent adverse events (TEAEs). TEAEs were reported by 20 of 30subjects (66.7%) who received VIS410 and by 7 of 11 subjects (63.6%) whoreceived placebo. 18 of 41 subjects (43.9%) overall (16 of 30 subjects[53.3%] who received VIS410 and 2 of 11 subjects [18.2%] who receivedplacebo; p>0.05) experienced TEAEs related to study drug. 14 of 16 TEAEsrelated to study drug were considered mild (Grade 1) and 2 were moderate(Grade 2).

Overall, the highest percentage of subjects that reported TEAEs wereclassified as nervous system disorders (11 subjects; 26.8%) followed bygastrointestinal (GI) disorders and infections and infestations (10subjects; 24.4% each). The percentage of subjects reporting nervoussystem disorders was similar following administration of VIS410 (7 of 30subjects; 23.3%) compared with placebo (4 of 11 subjects; 36.4%) and didnot reach statistical significance; no notable differences were observedacross VIS410 dose levels. Gastrointestinal disorders were reported bysubjects who received VIS410 only (10 of 30 subjects; 33.3% for VIS410receiving subjects, compared to 0% for placebo, p<0.05). The percentageof subjects reporting GI disorders was highest in the 50 mg/kg VIS410cohort (5 of 6 subjects; 83.3%). The percentage of subjects reportinginfections and infestations was similar following administration ofVIS410 (6 of 30 subjects; 20.0%) compared with placebo (4 of 11subjects; 36.4%); no notable differences were observed across VIS410dose levels (See Tables 6 and 7).

TABLE 6 Summary of Gastrointestinal Adverse Events VIS410 2 5 15 30 50Adverse mg/kg mg/kg mg/kg mg/kg mg/kg Total Placebo Overall Event (N =6) (N = 6) (N = 6) (N = 6) (N = 6) (N = 30) (N = 11) (N = 41) Diarrhea 02 1 2 5 10 0 10 (33.3%) (16.7%) (33.3%) (83.3%) (33.3%) (24.4%) Nausea 00 0 2 2 4 0 4 (33.3%) (33.3%) (13.3%) (9.8%) Vomiting 0 0 0 0 2 2 0 2(33.3%) (6.7%) (4.9%)

TABLE 7 Summary of Gastrointestinal Adverse Events by Severity VIS410 25 15 30 50 Adverse mg/kg mg/kg mg/kg mg/kg mg/kg Total Placebo OverallEvent (N = 6) (N = 6) (N = 6) (N = 6) (N = 6) (N = 30) (N = 11) (N = 41)Diarrhea 0 2 1 2 5 10 0 10 (33.3%) (16.7%) (33.3%) (83.3%) (33.3%)(24.4%) Grade 1 0 2 1 2 5 10 0 10 (33.3%) (16.7%) (33.3%) (83.3%)(33.3%) (24.4%) Grade 2 0 0 0 0 0  0 0  0 Grade 3 0 0 0 0 0  0 0  0Grade 4 0 0 0 0 0  0 0  0 Nausea 0 0 0 2 2  4 0  4 (33.3%) (33.3%)(13.3%) (9.8%) Grade 1 0 0 0 2 1  3 0  3 (33.3%) (16.7%) (10.0%) (7.3%)Grade 2 0 0 0 0 1  1 0  1 (16.7%) (3.3%) (2.4%) Grade 3 0 0 0 0 0  0 0 0 Grade 4 0 0 0 0 0  0 0  0 Vomiting 0 0 0 0 2  2 0  2 (33.3%) (6.7%)(4.9%) Grade 1 0 0 0 0 1  1 0  1 (16.7%) (3.3%) (2.4%) Grade 2 0 0 0 0 1 1 0  1 (16.7%) (3.3%) (2.4%) Grade 3 0 0 0 0 0  0 0  0 Grade 4 0 0 0 00  0 0  0 *Grade 1 = mild; Grade 2 + moderate; Grade 3 = Severe; Grade 4= Life-threatening

Additional summary safety data from the Phase I study is shown in Tables8 and 9.

TABLE 8 Subjects with Confirmed ADA and TEAE ADA Onset Time VIS410 Titerfrom Start Subject # Cohort (Day) TEAE Severity* Relationship ofInfusion 204 2 mg/kg 10 Headache Grade 2 Related 7 hrs (Day 120) 50 minsHeadache Grade 1 Not related 50 days 205 2 mg/kg 10 None (Day 14)reported 40 (Day 120) 208 2 mg/kg 40 Diarrhea Grade 1 Related 11 hrs(Day 120) 21 mins 305 15 mg/kg 10 None (Day 120) reported *Grade 1 =mild; Grade 2 + moderate; Grade 3 = severe; Grade 4 = serious adverseevent

Subjects who developed clinically significant upper respiratoryinfections had viral testing of their nasopharyngeal swabs by the siteinvestigator for the duration of the study (Day 120). None were found tohave influenza although the 30 mg/kg and 50 mg/kg cohorts were dosedfrom December 2014 to January 2015 where, based on state reportedepidemiology, there were high relative incidences of influenza A andother respiratory virus infections. A summary table of infections andinfestations lists the relevant infections and dose groups (See Table9). The most frequently reported TEAEs overall were diarrhea reported by10 of 41 subjects (24.4%) and headache reported by 8 of 41 subjects(19.5%). The most frequently reported drug-related TEAE overall wasdiarrhea (9 subjects; 22.0%) that generally occurred following infusionand spontaneously resolved within 24 hours. Most GI TEAEs were mild(Grade 1) with the exception of 2 subjects in the 50 mg/kg dose that hadmoderate (Grade 2) grading of their symptoms.

TABLE 9 Summary of Infections and Infestations VIS410 2 5 15 30 50 Totalmg/kg mg/kg mg/kg mg/kg mg/kg VIS410 Placebo Overall Adverse Event (N =6) (N = 6) (N = 6) (N = 6) (N = 6) (N = 30) (N = 11) (N = 41) AllInfections 0 0 1 3 2 6 4 10 and (16.7%) (50.0%) (33.3%) (20.0%) (36.4%)(24.4%) Infestations Upper 0 0 0 1 1 2 2  4 respiratory tract (16.7%)(16.7%) (6.7%) (18.2%) (9.8%) infection Appendicitis 0 0 0 0 0 0 1  1(9.1%) (2.4%) Corona virus 0 0 0 1 0 1 0  1 infection (16.7%) (3.3%)(2.4%) Gastroenteritis 0 0 1 0 0 1 0  1 (16.7%) (3.3%) (2.4%) Herpessimplex 0 0 0 1 0 1 0  1 esophagitis (16.7%) (3.3%) (2.4%) Herpes zoster0 0 0 0 0 0 1  1 (9.1%) (2.4%) Rhinitis 0 0 0 0 1 1 0  1 (16.7%) (3.3%)(2.4%) Rhinovirus 0 0 0 0 0 0 1  1 Infection (9.1%) (2.4%)

There were no subjects with SAEs that were related to study drug.Approximately 3 weeks following infusion, a subject that received 30mg/kg of VIS410 developed a primary HSV-1 infection with associatedesophagitis and transient leukopenia. Based on serological data, theHSV-1 infection was confirmed to be primary and given that the clinicalsequelae of HSV-1 were consistent with the clinical manifestations, theSAE was considered to be unrelated to the study drug by the siteinvestigator. This subject resolved their leukopenia spontaneously andresolved their esophagitis following treatment with valacycloviradministered by their treating physician. No subjects discontinued fromthe study due to a TEAE, and all TEAEs resolved by the end of the study.Overall, mean clinical laboratory results, vital sign measurements, andECG values observed after dosing were similar to baseline levels. Meanchanges from baseline were also similar across VIS410 dose levels, andno apparent treatment- or dose-related trends were observed.

Pharmacokinetic Results.

Mean AUC_(0-t), AUC_(0-∞), and C_(max) for VIS410 increasedapproximately proportional to dose (FIGS. 1A-1B and Table 10). Acrossthe dose cohorts, mean t_(1/2) values of VIS410 ranged between 250.72 to376.38 hours and median T_(max) values ranged between 1.92 and 3.50hours. The mean clearance values of VIS410 ranged from 11.41 to 14.07mL/hr and mean volume of distribution values ranged from 4,914.4 to6,189.8 mL, across all of the doses tested. A dose proportional increasein the C_(max) for VIS410 was observed, which ranged from 58.6 μg/mL ata 2 mg/kg dose to 1316 μg/mL at a 50 mg/kg dose. Additionally, PKsamples were examined for the presence of anti-drug antibodies (ADA). Ofnote, no preexisting ADAs were detected before administration of VIS410.It was found that four subjects (three at 5 mg/ml and one at 15 mg/mldose levels) developed low titer ADA, 120 days after administration ofVIS410. Notably, the presence of ADA did not alter drug PK as exclusionof ADA-positive subject data from the analysis did not substantiallyaffect calculated PK parameters, including half-life and drug exposure.

TABLE 10 Mean (CV) Serum Pharmacokinetic Parameters of VIS410 VIS410Parameter (unit) 2 mg/kg (N = 6) 5 mg/kg (N = 6) 15 mg/kg (N = 6) 30mg/kg (N = 6) 50 mg/kg (N = 6) AUC_(0-t) 10828 (11) 28026 (50) 90332(33) 163914 (41) 322070 (16) (hr · μg/mL) AUC_(0-∞) 11074 (12) 36086(25) 100410 (20) 190921 (10) 323451 (16) (hr · μg/mL) C_(max) (μg/mL)58.6 (16.8) 180.5 (29.6) 446.1 (13.6) 980.5 (16.7) 1316.0 (14.3) T_(max)(hr)^(a) 3.00 (1.92, 3.00) 3.50 (1.92, 4.00) 3.00 (1.92, 3.08) 2.46(1.92, 4.00) 1.92 (1.92, 3.00) t_(1/2) (hr)^(b) 250. 7 (11.6) 293.1(38.5) 341.2 (17.1) 288.6 (15.3) 376.4 (16.0) CL (mL/hr) 14.1 (10.4)12.6 (28.6) 12.9 (40.8) 11.7 (19.7) 11.4 (6.4) Vd (mL) 5089 (16) 4914(21) 6027 (22) 4779 (15) 6190 (17) Abbreviations: AUC, area under thecurve; C_(max), maximal concentration of VIS410; T_(max), time at whichmaximal concentration is achieved; t_(1/2), half-life; CL, clearance;Vd, volume of distribution; CV, coefficient of variation; hr, hours;K_(el), terminal elimination rate constant. Note: K_(el)-associatedpharmacokinetic parameters for Subject 202 (5 mg/kg VIS410) and Subject306 (15 mg/kg VIS410) were set to missing due to >20% extrapolation ofAUC_(0-∞). ^(a)For T_(max), the median (minimum, maximum) values arepresented. ^(b)VIS410 serum half-life (12.9 days), was calculated byaveraging the mean t_(1/2) of all cohorts.

Nasopharyngeal (NP) swabs were collected for the 15, 30, and 50 mg/kgVIS410 treatment groups but not for the 2 and 5 mg/kg groups. Followinga single IV infusion of VIS410 over 120 minutes, across the dose cohortstested, NP VIS410 concentrations appeared to increase with eachincreasing dose level, in a similar manner to serum C_(max) levels(Table 11 and FIG. 1A-1B). Mean NP VIS410 concentrations reached peaklevels within 24 hours after dosing for all the dose cohorts tested andremained measurable throughout the collection period. Mean NP VIS410concentrations for the ADA-negative subset were comparable to the PKanalysis set demonstrating that the ADA status did not influence VIS410NP concentrations.

TABLE 11 VIS410 Nasopharyngeal Pharmacokinetic C_(max) Statistics DoseMean C_(max) ± SD Cohort (mg/kg) n (μg/mL) 3 15 6 7.6 ± 5.2 4 30 6 20.0± 16.3 5 50 6 25.3 ± 10.4 C_(max)—Maximum observed nasal concentration.

Modelling of Population-Level Benefits.

Using the measured half-life and biodistribution information as well asinformation on protective levels in animals, it was modeled if apopulation-level prophylaxis strategy with VIS410 would be able toreduce influenza burden during a single influenza season. Themicrosimulation results indicated that prophylaxis of even a smallpercentage of the population can have a substantial impact on theoutcome of the epidemic as measured by the reduction in both attackrates and hospitalization rates for the elderly. Simulations werecarried out for a range of temperate-zone influenza epidemic scenarioscorresponding to attack rates between 4.8% and 27%. Attack rates andhospitalization rates for the 3 coverage levels explored in this studyare shown in Table 12. For a prophylactic dose of 8-fold over aprotective threshold of 1-2 mg/kg as estimated from preclinicalprophylactic experiments and with administration initiated 0-8 weeksprior to the epidemic peak, median reductions in attack rates from 50simulations were 8.6% (IQR: 4.7%-11.0%) for 2% coverage, 16.1% (IQR:8.1%-20.9%) for 4% coverage, and 22.6% (IQR: 12.7%-30.0%) for 6%coverage (FIG. 2A). The associated reductions in hospitalization of theelderly were 8.8% (IQR: 4.9%-11.6%), 16.5% (IQR: 8.8%-21.9%) and 22.9%(IQR: 13.0%-30.6%), respectively, for the three coverage scenarios (FIG.2C).

TABLE 12 Results of Microsimulation Measurements Coverage Metric AgeAdmin Untreated 2% (IQR) 4% (IQR) 6% (IQR) Attack Rate  0-5 all   9.1(6.7-12.7)   8.4 (6.0-11.7)   7.8 (5.4-10.8)   7.2 (5.0-10.1) (%)  elderly     8.9 (6.4-12.3)   8.6 (6.2-12.0)   8.4 (6.0-11.7)  6-15 all 15.6 (11.6-21.8)  14.5 (10.4-20.1)  13.6 (9.4-18.6)  12.6 (8.7-17.5)elderly    15.3 (11.2-21.1)  14.9 (10.7-20.7)  14.7 (10.5-20.2) 16-25all  13.1 (9.5-18.3)  12.1 (8.6-16.8)  11.3 (7.8-15.5)  10.4 (7.2-14.6)elderly    12.8 (9.2-17.6)  12.4 (8.9-17.3)  12.2 (8.6-16.9) 26-34 all 11.4 (8.2-15.9)  10.5 (7.4-14.6)   9.8 (6.7-13.5)   9.0 (6.2-12.7)elderly    11.1 (8.0-15.4)  10.8 (7.7-15.0)  10.5 (7.5-14.6) 35-49 all 18.6 (13.5-25.5)  17.1 (12.3-23.5)  16.0 (11.1-21.8)  14.8 (10.3-20.5)elderly    18.1 (13.1-24.7)  17.5 (12.6-24.2)  17.2 (12.3-23.6) 50-64all  12.3 (9.0-17.1)  11.4 (8.2-15.7)  10.7 (7.4-14.5)   9.8 (6.8-13.6)elderly  12.1 (8.7-16.5)  11.7 (8.4-16.1)  11.4 (8.1-15.6) >65 all   7.2(5.240.0)  6.6 (4.7-9.1)  6.2 (4.3-8.4)  5.7 (4.0-7.8) elderly  6.5(4.7-8.8)  5.8 (4.1-7.8)  5.2 (3.7-6.9) All all  13.1 (9.5-18.2)  12.1(8.6-16.7)  11.3 (7.8-15.4)  10.4 (7.2-14.5) Ages elderly  12.7(9.2-17.4)  12.3 (8.8-17.0)  11.9 (8.5-16.5) Hospitalization  0-5 all 72.1 (52.1-102.8)  67.5 (46.0-95.1)  62.9 (42.9-87.4)  58.3 (38.3-81.3)Rate (per   elderly  70.6 (49.1-98.2)  70.6 (47.5-96.6)  67.5(47.5-95.1) 100K)  6-15 all  5.3 (2.6-7.9)  4.4 (2.6-7.0)  4.4 (2.6-6.2) 4.4 (2.6-6.2) elderly  5.3 (3.5-7.0)  4.4 (2.6-7.0)  4.4 (2.6-7.0)16-25 all  27.0 (19.0-37.2)  24.8 (16.8-35.0)  22.6 (15.3-32.1)  21.2(13.9-29.9) elderly    26.3 (18.2-36.5)  25.5 (17.5-35.7)  24.8(16.8-35.0) 26-34 all  23.5 (16.1-31.6)  21.3 (14.4-29.3)  19.5(13.2-27.6)  17.8 (12.1-25.3) elderly    22.4 (15.5-31.0)  21.8(14.9-30.4)  21.3 (14.4-29.3) 35-49 all  31.5 (22.3-43.1)  29.1(20.3-39.7)  27.1 (18.5-37.3)  24.7 (16.9-34.9) elderly    31.0(21.8-42.1)  30.0 (20.8-41.2)  29.5 (20.3-40.2) 50-64 all  55.0(38.7-74.7)  51.1 (35.4-69.6)  47.2 (32.0-64.6)  43.2 (29.8-60.1)elderly  53.3 (37.6-73.0)  51.7 (36.5-70.7)  50.5 (35.4-69.1) >65 all272.4 (198.3-370.6) 249.2 (178.1-339.5) 230.8 (161.3-315.5) 212.5(148.6-296.3) elderly 243.6 (174.1-331.5) 217.7 (154.2-294.7) 194.1(137.4-262.0) All all  63.5 (46.1-86.7)  58.5 (41.4-79.4)  54.2(37.5-74.0)  49.7 (34.5-69.1) Ages elderly  59.0 (42.3-80.6)  55.1(39.1-75.3)  51.8 (36.6-69.7)

In addition to investigating coverage levels, it was assessed whetheradministration of VIS410 prophylaxis to the elderly would be animprovement over general population administration. In themicrosimulations, general-population administration results in largerreductions in attack rate than administration to the elderly alone,partially because of the nature of social contacts by which individualsare more likely to associate with those in their same age group.However, prophylaxis of elderly populations was associated with a largerreduction in elderly hospitalizations than distribution to thepopulation at large. The median reductions in >65 years oldhospitalizations were 11.4% (IQR: 8.2%-13.3%) for 2% coverage, 21.6%(IQR: 17.4%-24.9%) for 4% coverage, and 30.9% (IQR: 24.8%-35.1%) for 6%coverage when VIS410 was administered to the elderly only.Hospitalization rate in the elderly is an important outcome measure asthis age group makes up the majority of influenza hospitalizations andis particularly vulnerable to severe outcomes. Hospitalization ratesacross all age groups differed by a small amount (±4%) when comparinggeneral-population prophylaxis to prophylaxis of the elderly only (FIG.2B). The impact of VIS410 prophylaxis on seasonal influenza epidemicsshown in FIGS. 2A-2B represents an aggregation across a number ofsimulation variables (including severity of the epidemic, and date ofadministration of VIS410 relative to the date of peak activity). Whenthe analysis is restricted to a single epidemic scenario, the effect ofVIS410 on the severity of the epidemic is much more pronounced (FIG. 9).

An additional critical parameter that had a large influence on attackrates and hospitalizations was the timing of VIS410 deployment (FIG. 3).For an influenza season of moderate intensity, in the model describedherein, administration of VIS410 four to eight weeks prior to peakprevalence resulted in a reduction of hospitalizations of 34.3% (IQR:31.9%-36.6%) for 6% coverage, but the impact on hospitalizations wasmore marginal when administered zero to two weeks prior to the peak,with the reduction of hospitalizations at 13.9% (IQR: 12.1%-15.4%). Theabsolute case reduction of a prophylaxis strategy is very sensitive tothe individual protective period assumed for an administered dose ofVIS410, which is longer than 40 days in the model (FIG. 4). Ifprophylaxis is distributed too late, the majority of individuals willhave already been infected, but if given too early, the prophylacticeffects of VIS410 administration would wane before the major part of theepidemic wave passes through the population. Administration just priorto the peak is not optimal for population prophylaxis. At this period,approximately 30-40% of the season's infections have already occurred,and the opportunity is lost to protect individuals who become infectedduring the early and slow phase of the epidemic.

Influenza A remains a major public health threat based on seasonalinfections and the potential for pandemic infection. Monoclonal antibodytherapies like VIS410 that target broadly neutralizing epitopesrepresent a powerful class of therapies with multiple mechanisms ofanti-viral activity, including direct neutralization of either viralattachment or viral fusion, and Fc-mediated activity includingcomplement deposition and recruitment of cells of the innate immunesystem that enable the destruction of virus-infected cells (Longini etal. Science 2005; 309(5737): 1083-7; Brandenburg et al. PLoS one 2013;8(12): e80034). Additionally, as demonstrated here, the relatively safeprofile of an antibody therapy enables dosing at high levels throughbolus administration compared to many small molecule therapies.

VIS410 was initially developed for the treatment of hospitalizedpatients with influenza A for at least the following reasons. (1) Thereare no approved treatments for hospitalized influenza patients,representing a large unmet need. (2) Administration of polyclonalantisera has demonstrated the ability to reduce morbidity and mortalityin this population (Hung et al. Chest 2013; 144(2): 464-73). (3) Thedata from VIS410 in several preclinical models have demonstrated theability to rapidly reduce viral titers by greater than one log₁₀ andreduce ARDS in lethal models of H7N9 (Tharakaraman et al. Proc Natl AcadSci USA. 2015; 112(35):10890-5). (4) Pre-clinical data in the ferretsuggest that VIS410 can also prevent aerosol transmission of influenza(H1N1) despite its short half-life in this animal model (Lakdawala etal. Therapy or prophylaxis with an HA-stem antibody (VIS410) limitsrespiratory droplet transmission of influenza viruses in the ferretmodel. Options for the Control of Influenza VIII. Cape Town, SouthAfrica: International Society for Influenza and Other Respiratory VirusDiseases; 2013). (5) As demonstrated in this Phase 1 study, therelatively safe profile of an antibody therapy enables dosing at highlevels through bolus administration that can potentially enable a morerapid drop in viral loads compared to many small molecule therapies.

In this study, it was investigated whether VIS410 could be a usefultherapy and/or prophylactic countermeasure. To this end, it wasdemonstrated here that VIS410 is generally safe and well tolerated, evenat the relatively high dose levels of 30 mg/kg and 50 mg/kg. The mostcommon AE related to study drug was loose stool or diarrhea (10° F. 40subjects; 24.4%). Most subjects had minor and transient loose stool thatresolved spontaneously. Two of the six subjects at the highest dose of50 mg/ml had moderate diarrhea with associated nausea and vomiting thatresolved within 6 hours. None of the subjects with diarrhea had anyclinically significant issues such as hypotension and there were noassociated laboratory abnormalities. The time of onset and transientnature of these AEs suggest that they may be related to an infusionreaction and options such as slowing infusion or pretreatment can beexplored in future development to further mitigate these AEs.

There is precedence for infusion reaction related GI events aspreviously observed in both IVIG therapy and other monoclonal antibodiesand appears to be related to mast cell activation that correlates to theperiod around the C_(max) phase of the initial infusion. Serum PK wasapproximately dose proportional, and nasal PK of the target organ(nasopharyngeal/upper respiratory tract) demonstrated a partitioningcompared to serum of 1:53. ADA was observed at very low levels in 4/30subjects treated with VIS410. The presence of ADA in response totreatment with IgG1 monoclonal antibodies such as VIS410 is not uniqueand has been observed in marketed human monoclonal antibodies such asadalimumab.³⁶ If ADAs were to have a clinically-relevant impact onefficacy, it would be expected to observe a change in the PK of VIS410as a result of ADA appearance. This was not observed in this study.While this was a small study in healthy volunteers, and ADAs willcontinue to be monitored thru the development program, theseobservations would suggest that an impact of ADAs on acute treatment ora one-time prophylaxis of influenza is unlikely. However, it may belikely that the 13% (4 of 30) of subjects who produced ADAs, uponre-exposure to VIS410, would elicit a similar immune response andproduce ADAs again. Because the time-course to elicit the ADA responseupon re-exposure and clinical significance of this hypothetical concernis unknown, it would be difficult to speculate on the potential impactthat re-administration may have for VIS410 therapy either as a treatmentor prophylactic modality.

Given the phase 1 trial results, another question was addressed, thatis, whether VIS410 could be successfully deployed in the event of anepidemic outbreak to improve public health outcomes. Given VIS410'shalf-life, it was predicted that its distribution to the primary site ofinfluenza A infection (nasopharynx), and its potency, that limited,directed use of the agent would reduce the total burden of disease. Itis noted that universal prophylaxis is unlikely to be practical orfeasible. To test the hypothesis of the ability of VIS410 to reduceinfluenza disease burden, a micro-simulation of seasonal influenza thatis in good general agreement with observed attack rates was developed.In multiple scenarios, administration of a broadly neutralizing antibodylike VIS410 at an estimated dose of 8-16 mg/kg to the at-risk elderly,for example in nursing homes and within the hospital, prior to aninfluenza outbreak reduces the frequency of serious influenza. Thiseffect can be achieved even with administration of VIS410 at arelatively low coverage (between 2% and 6%), having a measurable impacton mitigating hospitalization events in an influenza outbreak.

Sensitivity analysis of the models indicates that timing ofadministration may be a crucial component of the decision-making processfor the deployment of VIS410 as a prophylaxis. The analysis suggeststhat between four to eight weeks prior to an epidemic peak is theoptimal timing for deployment, and this is also dependent on the dosegiven which determines the length of an individual's protective period.As recently developed climate-based models have made wintertimeinfluenza peak forecasting possible with a four to six week lead time,it can in fact be possible to have accurate enough influenza predictionto begin the early roll-out of a prophylaxis (Shaman et al. Naturecommunications 2013; 4: 2837; Shaman et al. Proceedings of the NationalAcademy of Sciences of the United States of America 2012; 109(50):20425-30). Another factor may be determining whether an influenza seasonwill be short or long, and the forecasting exercises would need to bere-run with this exact scenario in mind: timed deployment of apopulation-level prophylactic whose aim is to stem transmission andreduce hospitalizations in the elderly.

Desirable outcomes for influenza public health interventions includereductions in attack rates and hospitalizations across all age groups.For hospitalization reductions in particular, it is usually not possibleto prioritize one age group over another, and for this reason there is along unresolved question in influenza about the age-targeting of publichealth interventions (e.g., targeting high-contact or high-vulnerabilityindividuals for intervention). Targeting high-contact individuals mayhave a larger impact on mitigating the epidemic as a whole, includinglarger attack-rate reductions in high-vulnerability individuals (FIG.2A). On the other hand, targeting high-vulnerability individuals has amore direct and measurable impact on the individuals that receiveprophylaxis (FIG. 2C), and it may make it easier to argue for highercoverage levels if it can be clearly seen that protection is highlyefficacious on an individual level.

The general indirect benefits seen in this population modeling exerciseare seen in all population-level analyses of public health interventionsfor infectious disease. Precise outcomes from the population exercisemay be affected by, for example, geographic, demographic, and contactstructure of the population in question; individual variation in theprotective period; interaction between VIS410 therapy andacquisition/loss of influenza-specific immunity; and the sometimesunpredictable shape of influenza epidemics. For long-term effects ofVIS410 as a public health strategy and the relationship with immunity,it is noted that VIS410 targets a non-immunodominant epitope. As such,in animals, there is no measurable difference in the strength of thenative immunological response between infected, untreated animals, andinfected VIS410-treated animals. In both cases, re-challenge with thesame virus results in no infection due to a memory response. Forshort-term effects (single epidemic season), the general prophylaxisprinciples described in this analysis can be robust to differentcharacteristics of temperate-zone influenza epidemics, and individualcities or states can perform analyses and make decisions that arespecific to their populations and their past experience with influenza.

In summary, based on the results presented here, it was found that thesafety and pharmacokinetic profile of VIS410 allow for not only treatinginfluenza on an individual level but also as a public health strategy tomitigate the effects of seasonal or pandemic influenza based on itsability to reduce the overall burden of disease when strategicallyadministered in a vulnerable population.

Model Description

An individual-based epidemic microsimulation was developed in C++. Thesimulation was based on a previously developed model (Boni et al. (2013)Phil Trans R Soc L B 368: 20120207) and is similar in structure anddesign to an array of microsimulation models that have been developedover the past decade (Ferguson et al. (2005) Nature 437: 209-214;Germann et al. (2006) Proc Natl Acad Sci USA 103: 5935-5940; Longini andKoopman (1982) Biometrics 38: 115-126). The simulation has a 6-hourlytime step and asynchronous updating which is implemented with a specialscheduler class that keeps track of which individuals need updating atevery time step. The population is structured into households, andlocations (neighborhoods). Individuals spend 12 hours a day in theirhousehold potentially infecting household contacts (nighttime), and 12hours a day (daytime) in a pre-assigned location potentially infectingothers in the general population who are in the same location;general-population daytime contact rates are age-specific (Mossong etal. (2008) PLoS Med 5: e74). Individuals also engage in travel to randomlocations with a probability of 0.001 per timestep. The model has 1,000locations and one million individuals.

Individuals in the model can pass through any of eight clinical states:susceptible to infection, exposed to influenza virus, latently infected(i.e. infectious but with mild or no symptoms), infected with symptoms,severe influenza, hospitalized with severe influenza, recovered andimmune, and deceased. Individuals can be assigned to one of seven agegroups: 0-5, 6-15, 16-25, 26-34, 35-49, 50-64, and >65 years of age.

During the daytime time steps, a location-specific force of infection(FOI) is computed using the population contact structure and the agestructure of the infected individuals in that location. The FOI ismultiplied by a scaling parameter (β) and a Poisson random number(mean=β·FOI) of new individuals-to-be-infected (challenged by virus) isgenerated at each location at each daytime time step; each individual isthen selected for infection or non-infection according to their immunityand protection by VIS410 (see below). The parameter β is used tocalibrate the attack rates and epidemic shape/duration in the model (seebelow). In order to simulate the introduction of infected individualsfrom other populations, 10 random susceptible individuals (0.001%) wereinfected each day.

A seasonal forcing function for β was implemented using the positivepart of a cosine function to ensure that simulated epidemics peaked attimes consistent with observed epidemics. Although influenza epidemicscan peak at any point between December and March in northern temperatecountries, it was not necessary to include all of this variation, as theimportant feature for VIS410 administration will be how close to theepidemic peak the therapy is distributed and used.

Susceptible individuals in the model carry some level of natural partialimmunity to influenza which is based on their age and likelihood of pastinfection/vaccination. Natural or partial immunity is modeled simply ona scale of zero to one that describes an individual's relative immunityto infection if she/he encounters an infected contact. In other words, acompletely naïve individual would have an immunity of 0.0 and would meetinfectious individuals and contract an influenza infection proportionalto some rate β (general scaling parameter for transmission, from above).An individual that is partially immune with an immunity level of 0.67,for example, would be three times (1/(1−0.67)) less likely to becomeinfected under the same pattern of contacts as a completely naïveindividual; this individual would only have a 33% chance of becominginfected if he were challenged by virus. The mean immune levels fordifferent age classes are shown in the table below. These are modeled asnormal distributions with standard deviations set to 0.05. For theyounger age classes a fraction of individuals are assumed to becompletely naïve (immunity=0.0); age-specific rates for being consideredcompletely naïve are listed in Table 13. These assumptions are based onan average 15% annual attack rate (Keitel et al. (1997) Vaccine 15:1114-1122; Edwards et al. (1994) J Infect Dis 169: 68-76; Neuzil et al.(2002) J Infect Dis 185: 147-152) and vaccination rates in the US andEurope which are in the 15% to 50% range depending on country, season,and age group (Report MW (2012) Influenza Vaccination Coverage AmongHealth-Care Personnel—2011-12 Influenza Season, United States. 61:2008-2011; Blank et al. (2008) BMC Public Health 8: 272).

TABLE 13 Age-based immunity levels used in the microsimulations Age MeanImmunity- Fraction Group Level Naïve 0-5 0.50 0.3000  6-15 0.50 0.201916-25 0.40 0.0398 26-34 0.40 0.0100 35-49 0.40 0.0100 50-64 0.300.0100 >65 0.20 0.0100

For each individual, the level of VIS410 antibody circulating in thatperson's blood was tracked. A therapeutic dose is set to (1-2 mg/kg) andthis blood-concentration decays exponentially with a half-life of 13days. If an individual is selected for infection in a particulartimestep, that individual will be refractory to infection (i.e.,protected by VIS410) with probability equal to—

(Protective Efficacy_(VIS410))*(blood concentration)/(blood therapeuticconcentration)

In these simulations, the protective efficacy of VIS410 was set to 0.9,providing a maximum of 90% reduction in the probability of beinginfected when VIS410 levels are equal to or above the prophylactic dose(1-2 mg/ml). Individuals can receive 4-fold or 8-fold the prophylacticdose at the time of prophylaxis. A concentration below 0.1-fold theprophylactic dose is set to zero in the simulation. This behavior isshown in FIG. 4.

Age-specific hospitalization and mortality (given hospitalization) ratesare taken from previous studies (section below). Age and household sizedistributions were set for the US population (US_Census_Bureau (2014)Age Demographic and Housing Estimates.; Statista.com (n.d.) Distributionof Households in the US by Household Size. Accessed 6 Nov. 2015.).

Strategy Definitions

VIS410 prophylaxis strategies were modeled by considering the fractionof the population that would receive prophylaxis (the coverage f), thetime before the epidemic peak at which the treatment is distributed(between 0 to 8 weeks before the peak), and whether the treatment wasdistributed to individuals of all ages or only individuals over the ageof 65. VIS410 deployment for a given coverage level was spread equallyover a 14 day period after the desired date of administration. Coveragelevels of 2%, 4%, and 6% of the total population size were explored.

Model Validation

Infection Duration

Mean infection duration was set to a 1 day latent and infectious periodand 2.75 days (with a standard deviation of 0.75 days) of a symptomaticand infectious period, for non-severe patients based on the known courseof influenza infections (Carrat et al. (2008) Am J Epidemiol 167:775-785; Hien et al. (2010) PLoS Med 7: e1000277). Although some ofthese studies show viremia out to day 7, these data also show areduction in symptoms after days 3 or 4, and a difference in whetherinfluenza can be molecularly confirmed or virologically confirmed in thelate stages of infection. For individuals progressing to severeinfluenza, the duration of the severe stage of disease was set to 3.0days. A fraction (5%) of individuals progressed to severity, thus themean duration of a non-hospitalized influenza infection was 3.90 in thesimulation.

Household Infection Rates

During the nighttime time steps, household infections occur according topreviously inferred probabilities of household infection (Philip et al.(1961) Am J Hyg 73: 123-137; Longini et al. (1988) Am J Epidemiol 128:845-859; Longini and Koopman (1982) Biometrics 38: 115-126; Cowling etal. Ann Intern Med 151: 437-446; Cowling et al. (2010) N Engl J Med 362:2175-2184; Papenburg et al. (2010) Clin Infect Dis 51: 1033-1041; Petrieet al. (2013) PLoS One 8: e75339; Suess et al. (2012) BMC Infect Dis 12:26; Klick et al. (2011) Epidemiology 22: 793-796). Note that the resultsin these studies vary substantially depending on whether the strain waspandemic or seasonal, prior immunity in household contacts, oseltamiviruse in the study, and whether and at what time point influenza wasmolecularly/virologically confirmed. A probability of infection (givenan infected contact in a household) of 0.0216 per individual in asix-hour time step was chosen; this corresponds to an average 13%household attack rate for the duration of an infection for families with4 or 5 members.

Epidemics Duration and Attack Rate

The epidemic duration and attack rate are affected by β (thetransmission scaling parameter), migration between locations, immunitylevels, and household contact rates. Household infection rates werecalibrated separately so that the expected household attack rates wereachieved. Between-location movement rates affect the duration of theepidemic. Individuals moved on a daily basis to workplaces, schools, orother daily locations that were pre-determined. This movement rate wasset so that 1 in 250 individuals had random travel patterns assigned perday and calibrated so that the size and duration of the epidemiccorrespond to US influenza epidemic patterns.

Influenza attack rates in the US range from 5% to 25% (Longini et al.(1988) Am J Epidemiol 128: 845-859; Keitel et al. (1997) Vaccine 15:1114-1122; Edwards et al. (1994) J Infect Dis 169: 68-76; Neuzil et al.(2002) J Infect Dis 185: 147-152; Monto et al. (1985) Am J Epidemiol121: 811-822). These vary by age group and can be as high as 30% forchildren, depending on the influenza season. As most serological studieson seasonal influenza do not break individuals out into narrow age bands(with exceptions (Monto et al. (1985) Am J Epidemiol 121: 811-822;Hayward et al. (2014) Lancet Resp Med 2600: 16-19), it is difficult toknow much about age-specific attack rates except that (1) childrengenerally have higher attack rates than adults, and (2) elderly groupstend to have lower attack rates, but this needs to evaluated in light ofthe fact that elderly individuals can have low serological responses toinfluenza infection.

The duration of an influenza-like illness (ILI) season can be calibratedusing CDC's ILINet, which shows weekly ILI incidence, for the past 11years in 10 different regions in the US. Median duration is 15 weeks,and inter-quartile range is 10-20 weeks. These are epidemics of“influenza-like illness” which is defined syndromically, so the trueinfluenza season may be slightly shorter (this depends on the season,subtype, and other circulating viruses). To compute these ILI durations,region-specific baselines were computed from the ILI trends (bottom twoterciles of the data), and ILI rates that were two standard deviationsabove the baseline were considered as high ILI activity and used todefine the ILI season.

15 different epidemic scenarios were defined based on the transmissionparameter β (five different values) and on host immunity levels (threedifferent values). The five β values considered are: 0.36, 0.38, 0.40,0.425, and 0.45. And, three different scenarios of “relative levels ofpre-existing immunity”: 1.0 (a baseline or reference value), 0.94, and1.06, were considered.

The levels of pre-existing immunity differ in the age groups accordingto Table 14.

TABLE 14 Age-Based Pre-Existing Immunity Levels Used in theMicrosimulation Ages 0-15 Ages 16-49 Ages 50-64 Ages ≥65 Mean Immunityin 0.470 0.376 0.282 0.188 Scenario 1 Mean Immunity in 0.5 0.4 0.3 0.2Scenario 2 Mean Immunity in 0.530 0.424 0.318 0.212 Scenario 3

Here, the value represents the reduction in susceptibility to infectionif a person comes into sufficient contact with an infectious individual.The percentage naïve does not change for the different scenarios.

The age specific and overall attack rates for the fifteen differenttransmission scenarios are shown in Table 15.

TABLE 15 Median Attack Rates by Age Groups Relative Median Attack Rates(%) β immunity Ages 0-15 Ages 16-49 Ages 50-64 Ages >= 65 All Ages 0.360.94 15.87 17.40 14.49 8.26 15.45 1.00 10.03 11.04 9.25 5.31 9.84 1.065.92 6.43 5.46 3.24 5.77 0.38 0.94 17.93 19.79 16.47 9.49 17.56 1.0011.51 12.63 10.62 6.11 11.24 1.06 7.10 7.72 6.54 3.84 6.91 0.40 0.9419.83 21.71 18.22 10.57 19.35 1.00 13.23 14.60 12.24 7.12 13.01 1.068.12 8.98 7.56 4.41 8.00 0.425 0.94 22.82 25.16 21.17 12.34 22.45 1.0015.63 17.24 14.50 8.48 15.34 1.06 9.95 10.99 9.35 5.44 9.83 0.45 0.9425.58 28.37 23.96 14.06 25.31 1.00 18.61 20.44 17.25 10.10 18.22 1.0611.99 13.26 11.36 6.56 11.88

These fifteen scenarios were chosen (i.e., calibrated) in order toachieve attack rates in the 5% to 25% range and epidemic durations inagreement with CDC data on influenza-like illness incidence in theUnited States. Typical prevalence rates, attack rates, hospitalizationrates, and epidemic durations are shown in FIGS. 5-7.

Age-Specific Hospitalization and Mortality

The model construction requires us to assign the probability of aninfluenza infection becoming severe, the probability of a severeinfluenza infection being hospitalized, and the probability of ahospitalized influenza patient dying. The probability of progressingfrom non-severe symptomatic influenza to severe influenza is poorlydefined, as typically severity is measured in hospitalized patients butnot in the general patient pool. In the calibrations below, thisfraction was set to 5%; in other words, 5% of influenza infectionsprogress from “normal influenza” to “severe, but not necessarilyhospitalized or not yet hospitalized, influenza.” From these 5% thehospitalization and mortality rates can be calibrated as these data arecollected at national levels in the US and most other countries. UsingUS data these rates/probabilities were set to values shown Table 16.

TABLE 16 Age-Based Hospitalization and Mortality Rates Used in theMicrosimulation Age Group Hospitalization Prob Mortality Prob 0-5 0.16000.010  6-15 0.0065 0.020 16-25 0.0410 0.025 26-34 0.0400 0.033 35-490.0340 0.050 50-64 0.0880 0.066 >65 0.7500 0.066

Here, the hospitalization probability in the second column is theprobability of becoming hospitalized if one has a severe influenzainfection. The mortality probability is the probability of ahospitalized patient dying as a result of complications resulting frominfluenza infection.

Hospitalization rates were taken from previous studies of influenzaassociated hospitalization in the US (Thompson et al. (2004) J Am MedAssoc 292: 1333-1340; Bhat et al. (2005) N Engl J Med: 2559-2567; Dawoodet al. (2010) J Pediatr 157: 808-814; Jhung et al. (2011) Clin InfectDis 52 Suppl 1: S13-S26; Zhou et al. (2012) Clin Infect Dis 54:1427-1436). Depending on the hospital classifications used and theseverity of the influenza season, annual influenza-attributedhospitalization rates in the United States fall between 20 and 120 per100,000 individuals. For individuals over the age of 65, this rate fallsbetween 200 and 400 per 100,000.

For the fifteen transmission scenarios chosen for the analysis,general-population hospitalization rates fall between 28 and 123 per100,000. For the over 65 age group, these rates are between 200 and 370per 100,000 individuals.

Model calibration was performed for influenza A, where possible. A lowtransmission season in the model can also be considered one that ispredominantly influenza B. For a season that is mixed or approximatelyequally split between influenza A and influenza B, the reductions inattack rate and hospitalization resulting from VIS410 prophylaxis wouldbe lower.

Sensitivity Analysis

To perform a basic sensitivity analysis to various epidemiologicalscenarios, the transmission scenario (the transmission parameter 3 andthe pre-existing population immunity), the coverage level (2%, 4%, 6%),the date of administration of VIS410 prophylaxis (0, 2, 4, 6, and 8weeks prior to the peak), the dose given (4-fold or 8-fold), and whetherVIS410 was administered to all age groups or targeted only to theelderly, were varied. This represents 900 scenarios. Performing 50stochastic runs for each scenario yields 45,000 simulation outputs.

The Pearson partial correlation coefficients between a simulation outputand a simulation input (parameter), holding the other parametersconstant, are shown in Table 17.

TABLE 17 Partial Correlation Coefficients VIS410 VIS410 Pre-Administration administration, existing group (0 = all Dose (4-Population days prior to β immunity ages, 1 = elderly) or 8-fold)Coverage epidemic peak Attack Rate (all 0.912 −0.967 0.411 −0.089 −0.384−0.419 ages) Hospitalization 0.889 −0.955 0.077 −0.115 −0.450 −0.408Rate (all ages) Hospitalization 0.859 −0.938 −0.208 −0.134 −0.488 −0.394Rate (>65 only)

The signs and magnitudes in the first two columns are as expected.Increasing the transmission parameter or pre-existing populationimmunity has substantial effects on overall attack rates andhospitalizations.

As the administration parameter was “increased” from 0 (all ages) to 1(elderly only), a clear positive effect was seen on the attack rate, anda small positive effect on the total hospitalization numbers. The reasonthe hospitalization effect is small is that the increase in attack ratecomes in the least likely groups to be hospitalized, children and youngadults. As the administration parameter is “increased” from 0 to 1,hospitalizations in the elderly decline (PCC=−0.208) as expected as thisgroup benefits from direct protection due to VIS410 prophylaxis. Thiseffect is seen in the three panels of FIGS. 2A-2C.

As expected, increasing the dose or increasing coverage reduces attackrates and hospitalizations (fourth and fifth columns).

The final column shows the partial correlation between administrationtime and the attack rate/hospitalization outcomes. However, FIG. 3already shows that this relationship is non-monotonic. Hence, thenegative correlations should not be taken to mean that earlieradministration will always be associated with a reduction in attack rateor hospitalizations.

Epitope Analysis of Currently Circulating Strains of Influenza A

To assess the diversity of the amino acids comprising the predictedepitope of hemagglutinin (HA) targeted by VIS410, all HA sequences fromH1N1 and H3N2 collected from Jan. 1, 2012 through Jun. 30, 2015 wereanalyzed. Sequences were obtained from the EpiFlu database provided bythe Global Initiative on Sharing Avian Influenza Data (GISAID). 5,782H1N1 sequences and 10,210 H3N2 sequences were obtained. A multiplesequence alignment (MSA) for both H1N1 and H3N2 was created usingHMMalign version 3.1b1 against a curated sequence profile of HA. Usingthis MSA, the amino acid variation at positions predicted to be in theepitope were computed. Sequence variation at these positions is shown inthe sequence logo plots shown in FIG. 8, illustrating that the 25positions comprising the predicted epitope are highly conserved.

Detailed Phase I Study Design

VIS410 was administered as an IV infusion over at least 120 minutes.Randomization was used to reduce selection bias, double-blinding wasemployed to reduce potential bias during data collection and evaluationof safety variables, and the placebo group served as the control group.The dose-escalation design and the safety evaluation period withincohorts and between successive cohorts allowed for incremental safetyreview. In this study, subjects received the following doses: 2, 5, 15,30, and 50 mg/kg. These doses were consistent with serum concentrationsof VIS410 that were achieved during in vivo studies and demonstratedprotection from challenge with various influenza A strains andprevention of influenza spreading via respiratory droplets. See Table 18for the schedule of events.

Institutional research board approval was obtained prior to start of thestudy. Informed consent and Health Insurance Portability andAccountability Act (HIPAA) authorization were obtained at the screeningvisit. The screening visit was conducted within 30 days of study productinfusion (Days −30 to −1).

Inclusion Criteria

For inclusion in the study, each subject was required to meet all of thefollowing criteria at screening:

-   1. After the nature of the study was fully explained, the subject    read, understood, and signed the IRB-approved ICF which provided    written informed consent and HIPAA authorization.-   2. Aged ≥18 and ≤55 years.-   3. Had a body mass index ≥18 and ≤33 kg/m², inclusive, and weighed    ≤90 kg for subjects in Cohort 5 receiving a 50-mg/kg dose.-   4. Was in general good health without history of any of the    conditions listed in the exclusion criteria.-   5. Nonsmoker for at least 6 months.-   6. A woman agreed not to become pregnant from the time of study    enrollment until at least 3 months after the completion of the    monoclonal antibody infusion. If a woman was sexually active and had    no history of hysterectomy or tubal ligation, she agreed to use    hormonal birth control, barrier method of birth control with    spermicidal gel, or an intrauterine device and continued using    approved contraception for at least 3 months after the completion of    the VIS410 infusion. These birth control measures were not    applicable for postmenopausal women, defined as either having    amenorrhea for ≥12 months or follicle-stimulating hormone >40    MIU/mL.-   7. Sexually active male subjects agreed to use a barrier method of    birth control with spermicidal gel during the course of the study    and continued using a barrier method of birth control for at least 3    months after the completion of the VIS410 infusion.-   8. Subject had screening laboratory values that met the following    criteria:    -   a. White blood cells: 3000 to 12 000/mm³    -   b. Platelets: >150 000/mm³    -   c. Hemoglobin: >13 g/dL (male) or >12 g/dL (female)    -   d. Creatinine: ≤1.40 mg/dL    -   e. Blood urea nitrogen: ≤25 mg/dL    -   f. Aspartate aminotransferase: ≤50 IU/L    -   g. Alanine aminotransferase: ≤67 IU/L    -   h. Alkaline phosphatase: ≤150 IU/L    -   i. Bilirubin: ≤1.4 mg/dL    -   j. Glucose (fasting): <115 mg/dL    -   k. Drug and alcohol screen: Negative

Exclusion Criteria

Any of the following was regarded as a criterion for exclusion of asubject from the study:

-   1. Previously received an antibody or biologic therapy, whether    licensed or investigational (e.g., immunoglobulin products,    monoclonal antibodies, or antibody fragments).-   2. History of any of the following illnesses or conditions: cancer,    heart disease, diabetes mellitus, respiratory condition (such as    asthma requiring daily medication), autoimmune disorder, blood    dyscrasias, or psychiatric disorder that precluded compliance with    protocol.-   3. Any chronic condition that required daily prescription or    over-the-counter medicine, except for vitamins and birth control    products.-   4. Abused drugs or alcohol within the previous 12 months.-   5. History of a previous severe allergic reaction with generalized    urticaria, angioedema, or anaphylaxis.-   6. Physical finding on an examination considered clinically    significant, such as murmur (other than functional),    hepatosplenomegaly, lymphadenopathy, or focal neurological deficit.-   7. Blood pressure >160/100 or <90/50 on 2 separate readings.-   8. Urinalysis results determined to be clinically significant per    investigator discretion.-   9. Positive serology for human immunodeficiency virus antibody,    hepatitis C virus antibody, or hepatitis B surface antigen.-   10. Positive urine pregnancy test during screening or within 24    hours of monoclonal antibody administration or an unwillingness to    undergo pregnancy testing for female subjects.-   11. Positive drug or alcohol testing at screening or within 24 hours    of monoclonal antibody administration.-   12. Breastfeeding.-   13. Received another investigational study agent within 30 days or 5    half-lives, whichever was longer, before administration of the study    product.-   14. Received any live virus or bacterial vaccinations within 3    months prior to screening or was expected to receive any live virus    or bacterial vaccinations during the study.-   15. Received inactivated influenza vaccines within 2 weeks of Day 0    or was expected to receive an inactivated influenza virus during the    study.-   16. Any other condition that, in the opinion of the investigator,    would have jeopardized the safety or rights of the subject    participating in the study, or made it unlikely the subject could    have completed the protocol.

TABLE 18 Schedule of Events Procedure Screening Study Time AfterInfusion (days) Time Point (Day) −30 to −1 0^(a) 1 2 3 7 14 28 56 120Study Visit 1 2 3 4 5 6 7 8 9 10 Informed consent/HIPAA X authorizationInclusion/exclusion criteria X Demographics and medical history X Serumfor hepatitis panel and HIV X Drug and alcohol toxicology screen^(b) X XPregnancy test X X Vital signs^(c) X X X X X X X X XElectrocardiogram^(d) X X Physical examination^(e) X X X X X X Clinicadmission^(f) X PK sampling^(g) X X X X X X X X X ADA sampling^(h) X X XX Study infusion X Hematology^(i) X X X X X X X Serum chemistry/liverfunction tests^(i) X X X X X X X Urinalysis^(i) X X X X X X XConcomitant medications X X X X X X X X X X Adverse events^(j) X X X X XX X X X Nasopharyngeal swabs^(k) X X X X Abbreviations: ADA, antidrugantibodies; HIPAA, Health Insurance Portability and Accountability Act;HIV, human immunodeficiency virus; PK, pharmacokinetic. ^(a)The first 2subjects of each cohort may have been admitted at Day −1 to facilitatepre-infusion procedures, although these subjects received study drug orplacebo on Day 0. The pre-infusion activities for these subjects mayhave occurred on Day −1 or Day 0. ^(b)Drug and alcohol toxicologytesting was performed within 24 hours of starting monoclonal antibodyinfusion. ^(c)Vital sign measurements were recorded at screening and onDay 0 at the start of study infusion (±5 minutes), during the infusionat 15-minute intervals for 60 minutes, then every 30 minutes until theend of infusion. After the end of infusion, vital signs were obtained at30, 45, 60, and 90 minutes, and 2, 3, 6, 8, 14, and 20 hours until thesubject was discharged from the clinic. ^(d)On Day 0, there were 2triplicate 12-lead electrocardiograms performed: one before infusion andone at the end of infusion (±10 minutes). ^(e)Physical examinations wereperformed at the screening visit, on Day 0 before the infusion, upondischarge from the clinic on Day 1 after the infusion, and on Days 3, 14± 1, and 56 ± 7 after the infusion, for applicable subjects. Targetedphysical examinations may have been performed at other study visits asneeded for adverse event assessment. ^(f)Each subject was admitted tothe clinic for his/her designated monoclonal antibody infusion.Discharge from the clinic unit did not occur before the 24-hourpost-infusion study procedures were performed. ^(g)On the day of studyinfusion (Day 0, Visit 2), serum samples for PK analysis were collectedbefore the start of infusion; at the end of the infusion; and at 60minutes, and 2, 8, and 24 hours after the end of infusion. Subjects hadPK samples drawn on Days 2, 3, 7, 14 ± 1,28 ± 3, 56 ± 7 and 120 ± 7after the infusion. hSubjects had serum samples collected for ADAanalysis before the infusion and on Days 14 ± 1, 56 ± 7, and 120 ± 7after the infusion. ^(i)On the day of study infusion (Day 0, Visit 2),blood samples for hematology and serum chemistry/liver function tests,and urinalysis samples were collected before the start of the studyinfusion. ^(j)On the day of study infusion (Day 0, Visit 2), adverseevents were assessed from the start of the infusion until discharge fromthe clinic at scheduled time points per the protocol, and as needed.^(k)Nasopharyngeal swabs (one from each nostril) were collected fromsubjects in the 15, 30, and 50 mg/kg cohorts on Day 0 before the startof infusion, at 8 and 24 hours after the end of infusion, and on Days 3and 7 after the infusion.

Example 2: Preclinical Animal Data Supporting Prophylactic Dose LevelMethodology

An A/Puerto Rico/8/1934(H1N1) lethal mouse models was employed. Animalswere administered antibody IP in a volume of 200 μL as prophylaxis oneday prior to infection. Then, mice were anaesthetized under isofluraneand challenged i.n. with 50 pL viral suspension (˜100 pfu). Weight andappearance of the animals were recorded daily. Animals were euthanizedupon loss of considerable weight (>20%) in conjunction with high bodyscore indicating illness. Lungs were harvested from a subgroup ofanimals on day four post-infection for the determination of viral loadby plaque assay. In addition, lungs on day eight were submitted forhistological examination.

Results

The study was completed as follows (Table 19).

TABLE 19 Experimental Design Agent Dose (mg/kg) Administration PBS(Vehicle) — — Ribavirin 75 (3 −24 hours, +24 hours, +48 doses) hoursVIS410 10 24 h prior to infection VIS410 2.5 24 h prior to infectionVIS410 0.6 24 h prior to infection

Visual Cues

Animals were monitored for signs of illness (ruffled fur, hunching)daily. Untreated mice that were challenged with H1N1 appeared sick threedays post-infection and were euthanized on day seven, as expected. Micethat were challenged with H1N1 and treated with three doses of ribavirinexhibited negligible signs of illness and recovered fully (FIGS.10A-10B). Mice that were treated with VIS410 one day prior to challengeat 2.5 mg/kg or 10 mg/kg exhibited no sign of illness. Mice that weretreated with VIS410 at 0.6 mg/kg one day prior exhibited some signs ofillness, with 60% of animals surviving.

Viral Load

The lung viral loads four days after H1N1 infection were assessed in asingle plaque assay (Table 20). Comparisons were made between treatmentgroups to assess the significance of the reductions in lung viral load.Significance (p<0.05) was determined Mann Whitney U test. The lung viralload in all treatment arms was significantly different from that in theuntreated group.

TABLE 20 Lung Viral Load in Mice Four Days after Challenge with H1N1 PR8Group Dose (mg/kg) Lung Viral Load Untreated — 6.03 Ribavirin 75(×3)4.38 VIS410 10 4.45 VIS410 2.5 4.08 VIS410 0.6 5.38

Example 3: Evaluation of Efficacy and Emergence of Resistance to anAnti-HA Antibody Molecule in a Human Challenge Model of Infection with ap2009 H1N1 Virus

In this study, the efficacy and emergence of resistance to an exemplaryanti-HA antibody molecule (i.e., VIS410) was evaluated.

Methods

The efficacy and emergence of viral resistance to VIS410 were evaluatedin a Phase 2a human challenge study in healthy volunteers with an H1N1strain isolated during the 2009 pandemic (p2009 HINI). Eighteen subjectsreceived a single intravenous 2300 mg dose of VIS410 24 hours afterviral inoculation. Influenza virus replication from nasopharyngeal swabspecimens was measured by tissue culture infectious dose 50 (TCID50)assay and quantitative PCR methods. Emergence of resistance was assessedby using both phenotypic and genotypic approaches to characterizeinfluenza viruses in nasopharyngeal swab specimens from subjects.Briefly, phenotypic resistance was assessed by culturing virus in thepresence or absence of pre-defined concentrations of VIS410 anddetecting virus outgrowth by nucleoprotein ELISA and viral fociimmunostaining. Genotypic resistance was assessed by performing nestedSanger population sequencing of the full-length HA gene and nextgeneration sequencing to detect potential minority species.

Results

VIS410 demonstrated potent antiviral activity at 2300 mg with a 91% and76% reduction in median viral load AUC compared to placebo for TCID₅₀and qPCR, respectively. There was no emergence of resistance followingadministration of a single 2300 mg dose of VIS410. Influenza virusescultured from nasopharyngeal swab specimens were uniformly sensitive toVIS410 neutralization in vitro. Additionally, Sanger and next generationsequencing did not reveal any deleterious adaptations that would affectVIS410 binding/function.

Thus, a single dose IV administration of VIS410 at 2300 mg providedpotent antiviral activity and no viral resistance exhibited in thisstudy.

Example 4: Pharmacokinetics of an Anti-HA Antibody Molecule in a HumanChallenge Model of Infection with p2009 H1N1 Virus

In this study, the pharmacokinetics of an exemplary anti-HA antibodymolecule (i.e., VIS410) was evaluated.

Methods

Serum and nasal pharmacokinetics (PK) of VIS410 have been characterizedin a Phase 2a human challenge study in healthy volunteers, with an HINIstrain isolated during the 2009 pandemic (p2009 H1N1). This randomized,placebo-controlled, double-blind study evaluated the PK of a single 2 hIV infusion of VIS410 (2300 mg) administered 24 h after inoculation.Blood samples for PK analysis and for assessment of antidrug antibodies(ADA) to VIS410 were collected before and up to 84 days post infusion inall VIS410 subjects (n=18). Nasopharyngeal samples were collected fornasal PK up to Day 10 to assess VIS410 concentration at the site ofinfection. VIS410 concentrations were analyzed using a validated ELISAmethod. Standard non-compartmental methods were used to estimate PKparameters in serum and nasal mucosa.

Study Design

This study was a randomized, double-blind, placebo controlled, Phase 2ahuman challenge study. Data presented are from the interim analysis ofthe 31 healthy volunteers. Subjects were inoculated intranasally (Day 1)with approximately 106 tissue culture infective dose (TCID50) ofinfluenza A (H1N1) strain isolated during the 2009 pandemic. One day (24hours) after inoculation (Day 2), subjects received a single intravenousadministration of 2300 mg of VIS410 (n=18) or placebo (0.9% sodiumchloride) (n=13).

Serial blood samples for determination of VIS410 serum concentrationwere collected. Serum VIS410 concentrations were determined using avalidated ELISA with a lower limit of quantification of 50 ng/mL. Serialnasopharyngeal swabs for determination of VIS410 nasal concentration andviral shedding were collected. Nasal mucosa VIS410 concentrations weredetermined using a validated ELISA with a lower limit of quantificationof 0.50 ng/mL.

Nasal and serum PK parameters were determined using standardnon-compartmental methods using Phoenix WinNonlin software. Serum PKsamples were collected pre-dose and at serial times relative to the endof infusion. Nasal PK and viral samples were collected Day −2 (prior toinoculation), pre-dose and at serial times relative to the end ofinfusion. Non-parametric Mann Whitney U test was used to assess thedifference between treatment groups in the area under the viral loadtime curve (AUC) for H1N1 based on qRT-PCR and TCID50 fromnasopharyngeal swabs.

Results

All 18 VIS410 subjects were included in the PK analysis. Of the 31randomized and treated subjects, 20 (7 placebo and 13 VIS410) wereincluded in the analysis of viral shedding. Seven subjects (4 placeboand 3 VIS410) were excluded due to baseline HAI titer of >10 to thechallenge virus and 4 subjects (2 placebo and 2 VIS410) were excludedfor not being infected post inoculation. Mean serum and nasal PKparameters are presented in Table 21. The mean serum and nasalconcentration versus time profiles are presented in FIGS. 11A-11B,respectively. Statistically significant reduction in viral AUC and peakviral load was observed with a single dose of VIS410 2300 mg vs. placebo(Table 22). All data are presented as mean (CV %).

TABLE 21 Mean Serum and Nasopharyngeal VIS410 PK Parameters C_(max)T_(max) AUC_(0-last) T_(last) AUC_(0-∞) AUC_(%extrap) Vd CL Treatment(μg/mL) (day) (day*μg/mL) (day) (day*μg/mL) (%) (mL) (mL/day) SerumVIS410 N 18 18 18 18 18 18 18 18 2300 Mean 792 0.260 6,900 55.2 7,1503.49 5530 334 mg CV % 32.3 94.1 19.5 5.87 19.4 42.9 25.8 20.0 NasalVIS410 N 18 18 18 18 2300 Mean 28.4 3.73 81.6 8.04 mg CV % 112 72.8 92.20.507

TABLE 22 Interim Analysis of Antiviral Effect of VIS410 2300 mg Comparedto Placebo (mITT population) Placebo VIS410 Viral Measure (N = 7) (N =13) Reduction p Value Median Viral AUC 552 47.1 91% 0.019 TCID₅₀ (log₁₀Xhours) Median Viral AUC 1033 232 76% 0.024 qPCR (log₁₀X hours) MedianPeak Viral Load 5.00 2.75 2.3 0.009 TCID₅₀ (log₁₀) Median Peak ViralLoad 7.14 5.61 1.5 0.043 qPCR (log₁₀)

Based on preliminary data following a 2300 mg dose (n=18) the serumC_(max) was 792 (32%) μg/mL, AUC_(0-last) 7150 (19%) μg*d/mL, clearance334 (20%) mL/d, and a long half-life of approximately 12 days.Nasopharyngeal concentrations of VIS410 exceeded the in vitro EC₅₀(0.3-11 μg/mL) of the majority of influenza strains tested within 6hours of dosing (mean [CV %] concentration after 6 h was 5.6 [140%]μg/mL; C_(max) for nasopharyngeal concentrations was 28.4 [112%] μg/mLand remained elevated through Day 8 [9.7 (120%) μg/mL]). VIS410 alsodemonstrated potent antiviral activity at 2300 mg with a 2.3 and 1.5log₁₀ reduction in median peak viral load compared to placebo for TCID₅₀and PCR, respectively. None of the subjects were tested positive forADA.

Serum PK in this study is consistent with those of a human IgG1antibody. The observed half-life of approximately 12 days supports asingle dose administration of VIS410 in patients with influenza Ainfection. Nasopharyngeal concentration versus time profiles were highlyvariable and a clear elimination phase was not evident in the majorityof profiles. A single VIS410 dose of 2300 mg resulted in a statisticallysignificant reduction in both viral AUC and peak viral load compared toplacebo. Thus, a single dose IV administration of VIS410 at 2300 mgprovides potent antiviral activity, which is consistent with theobserved high and sustained systemic and nasopharyngeal exposures inrelation to the in vitro EC₅₀.

Example 5: Safety and Efficacy of the Monoclonal Antibody VIS410 in aHuman Volunteer Challenge Model of Infection with an H1N1 Influenza AVirus Methods

The efficacy of VIS410 was tested in a Phase 2a human challenge studywith an H1N1 strain isolated during the 2009 pandemic. This randomized,placebo-controlled, double-blind study was designed to assess theefficacy and safety of VIS410 in healthy human volunteers challengedwith influenza A. Twenty-four hours after viral inoculation, subjectswere randomized to receive either VIS410 or placebo and monitored forviral shedding by nasopharyngeal swabs, clinical symptoms andpharmacokinetics. A total of 31 subjects were randomized, all of whomeither received VIS410 as an intravenous infusion at a dose of 2300 mgor placebo.

Study Design

This study was a randomized, double-blind, placebo controlled, Phase 2ahuman challenge study. The primary objectives were to assess the safetyand tolerability of VIS410 and the effect of VIS410 on the area underthe curve of viral shedding over time (viral AUC).

Healthy adult volunteers (N=31) were inoculated intranasally (Day 1)with approximately 106 tissue culture infective dose (TCID) of influenzaA (H1N1) strain isolated during the 2009 pandemic. One day (24 hours)after inoculation (Day 2), subjects received a single intravenousadministration of 2300 mg of VIS410 (n=18) or placebo (0.9% sodiumchloride) (n=13). Nasopharyngeal swabs for determination of viralshedding were collected on Day −1 (prior to inoculation), pre-dose andat 0, 6, 12, 24, 30, 36, 48, 54, 60, 72, 78, 84, 96, 102, 108, 120, 126,132, 144, 150, 156, 168, 174, 180, 192, 198, and 204 hours relative tothe end of infusion.

The quantity of influenza virus from nasopharyngeal swab specimens wasmeasured by tissue culture infectious dose 50 (TCID50) assay andquantitative RT-PCR (qRT-PCR) methods. A symptom score card was used torecord the incidence, severity and duration of signs and symptoms ofinfluenza-like illness through Day 10.

The modified intent-to-treat (mITT) population used in the PD analysiswas defined as all randomized subjects who received study drug who metthe inclusion criterion of seronegativity by hemagglutinin inhibitionassay (HAI) (≤10) on Day 1 and were infected, defined by eitherseroconversion (≥4×HAI titers from baseline) or measurable viral load (2consecutive qRT-PCR time points above the level of quantification).Standard non-compartmental approaches using Phoenix WinNonlin (PharsightCorporation, Princeton, N.J., USA; Version 6.3) were used to calculatepeak viral load (VL) and VL AUC. Non-parametric Mann Whitney U test wasused to assess the difference between treatment groups in the area underthe viral load time curve (AUC) for H1N1 based on qRT-PCR and TCID50from nasopharyngeal swabs

Results

All 31 subjects received study drug and were included in the safetyanalysis. Of the 31 randomized and treated subjects, 20 (7 placebo and13 VIS410) were included in the mITT PD analysis of viral shedding.Seven subjects (4 placebo and 3 VIS410) were excluded due to baselineHAI titer of >10 to the challenge virus and 4 subjects (2 placebo and 2VIS410) were excluded for not being infected post inoculation.

A robust H1N1 infection model was achieved with median peak viral loadof >4.5 log 10 by TCID50 and >7 log 10 by qPCR. VIS410 was generallysafe and well tolerated with adverse events reported in 76.9% and 94.4%of the subjects in the placebo and VIS410 treatment arm, respectively.

There were no drug-related discontinuations, serious adverse events, ordeaths in the study. Gastrointestinal disorders were the most commonlyreported events in the VIS410 arm (88.9%) vs. placebo (15.4%). Abdominalpain and loose stool were the most commonly reported GI events (61.1%and 50%, respectively in the VIS410 arm). Use of a pretreatment regimencontaining a histamine blocker (diphenhydramine 50 mg PO) reduced theseverity of the GI events with majority (54.5%) being mild

Statistically significant reduction in viral AUC and peak viral load wasobserved with a single dose of VIS410 2300 mg vs. placebo (Table 22)

The median duration of viral shedding measured by qRT-PCR was 5.29 days(mean=4.92 days) for VIS410 2300 mg and 7.78 days (mean=6.52 days) forplacebo, while the median time to resolution of viral shedding was 5.21days (mean=5.23 days) and 8.24 (mean=7.37 days) for VIS410 2300 mg andplacebo, respectively (FIG. 12A). The TCID₅₀ versus time profiles ofVIS410 compared to Placebo as measured by a cell based assay are shownin FIG. 12B.

Upper respiratory symptoms resolved a median of 2 days faster in theVIS410 treatment group versus placebo (FIG. 13).

VIS410 was generally safe and well tolerated with a pre-treatmentregimen that included over-the-counter oral anti-histamines and NSAIDs.There were no drug-related discontinuations, serious adverse events, ordeaths reported in this study. The overall area-under-the-curve (AUC) ofviral shedding for the VIS410 treated subjects was 91% (p=0.019) lowerthan the placebo group, as measured by the cell based assay TCID₅₀, and76% (p=0.024) lower than the placebo group, as measured by viral RNAquantitation (qPCR). Peak viral levels for the VIS410 treatment groupswere 2.2 logs (p=0.009) lower than placebo, as measured by the cellbased assay TCID₅₀, and 1.5 logs (p=0.043) lower, as measured by qPCR.Furthermore, subject-reported upper respiratory symptoms resolved amedian of 2 days faster in the VIS410 treatment group versus placebo.

Phenotypic resistance was tested using ViroSpot™ assay and based on IC50values. No phenotypic variants were identified by ViroSpot™ assay (27samples assessed). Phenotypic assessment of IC50 revealed similar medianof Placebo vs. VIS410 (25 samples). The results are shown in FIGS.14A-14B. No resistant variants were identified.

The study achieved its primary endpoint of reducing the viral sheddingarea-under-the-curve in the VIS410 treatment group and showed a trendtowards a shorter duration and lesser magnitude of upper-respiratorysymptoms. VIS410 was generally safe and well tolerated with apre-treatment regimen that included over-the-counter oralanti-histamines. A single VIS410 dose of 2300 mg resulted in astatistically significant reduction in both viral AUC and peak viralload compared to placebo. VIS410 showed a trend towards reduction induration of viral shedding and the duration and severity of upperrespiratory symptoms compared to placebo.

Example 6: Evaluation of Antibody Dependent Enhancement (ADE) inPreclinical Models of Influenza A Virus Infection Treated with anAnti-HA Antibody Molecule

Antibody dependent enhancement (ADE) is the phenomena wherenon-neutralizing concentrations of antibodies can bind to virusparticles and enhance disease by mediating entry into Fc-bearing cells,such as macrophages, consequently increasing virus tropism andpathogenesis. Data describing ADE during influenza infection in vivo islimited to preclinical and retrospective clinical vaccine studies, wherepolyclonal immune responses were found to elicit increased inflammationand pathology during heterologous influenza virus infection. With theadvent of broadly neutralizing anti-viral monoclonal antibody therapiesthere is an increased need to understand the proposed therapeuticmechanisms and unintentional immunologic and virologic impact of theseantibodies on disease progression. In this study, ADE potential of anexemplary anti-HA antibody molecule (i.e., VIS410) was evaluated in anin vivo efficacy model.

Methods

VIS410 was evaluated in 6-8 week old female CD-1 mice challenged with alethal dose 25 (LD₂₅) of mouse-adapted A/Puerto Rico/8/34 (H1N1) orA/Victoria/3/75 (H3N2). Four hours after virus inoculation, doses ofVIS410 (0.02, 0.2, 2, 20 mg/kg) and irrelevant human IgG1 antibody(0.02, 20 mg/kg) were administered intravenously. This dose rangerepresented both protective and sub-neutralizing levels of VIS410, whichcould be compared for efficacy or enhancement to the corresponding dosesof control antibody. Groups of mice were either harvested at the peak ofinfection or monitored for 14 days for weight-loss, clinical score andsurvival, all mice were evaluated for lung viral load and pathology.

Study Design

The study design is illustrated in FIG. 15.

Results

VIS410 treatment in mice demonstrated a dose dependent protection fromweight-loss, clinical signs, and mortality during infection with H1N1and H3N2 influenza A viruses. As shown in FIGS. 16A-16B, VIS410protected CD-1 mice from influenza A virus-induced morbidity in a dosedependent manner as compared to irrelevant human IgG1. FIG. 14 shows theaverage lung viral load on Days 1 and 14. As shown in FIG. 17, lungviral loads were equivalent between 0.02 mg/kg VIS410 and placebotreated animals on Day 1 post infection (pi) (H1N1 6.1±0.4 vs. 6.3±0.6TCID₅₀/g; H3N2 3.9±1.8 vs. 5.1±0.8 TCID₅₀/g, respectively), with allanimals that survived to Day 14 pi successfully resolving infection.

Immunohistochemistry and pathology also correlated with dose, withanimals receiving the higher doses of VIS410 displaying less viralantigen staining and decreased inflammation while animals treated with0.02 mg/kg VIS410 or placebo had the greatest viral antigen staining atDay 1 pi and highest pathology scores at Day 14 pi.

TABLE 23 Day 1 IHC and Day 14 pi Lung Pathology in H1N1 InfluenzaInfected CD-1 Mice Treated with Different Doses of VIS410 and IrrelevantHuman IgG1 VIS410 Placebo Immunohistochemistry 20 mg/kg 2 mg/kg 0.2mg/kg 0.02 mg/kg 20 mg/kg 0.02 mg/kg Trachea/Primary NP − +/− ++ NP −Bronchus (IHC) NP − + NP − NP − NP NP NP + ++ +/− NP + − − +/− +/− NP −+/− + ++ Bronchioles (IHC) − − − +/− − ++ − − − − − − − − +/− − − ++ − −− − − − − − − +/− + − IHC Immunohistochemistry for influenza A VirusNucleoprotein (NP) Demonstrating Virus Replication NP Not Present,Therefor Not Evaluated IHC Score: − All negative +/− 1-Few Nuclei StainFaintly Positive for IAV-NP or “Suspect Positive” + Few Nuclei StainPositive for IAV-NP ++ Several Nuclei Stain Positive for IAV-NP +++ ManyNuclei Stain Positive for IAV-NP VIS410 Placebo Pathology 20 mg/kg 2mg/kg 0.2 mg/kg 0.02 mg/kg 20 mg/kg 0.02 mg/kg Extend of Alveolitis 0.07± 0.26^(b) 0.67 ± 0.49^(a) 1.36 ± 0.84 1.92 ± 1.04 1.50 ± 0.76 1.80 ±0.92 (Score 0-3) Severity of Alveolitis 0.13 ± 0.52^(b) 1.13 ± 0.99 2.07± 1.14 2.00 ± 0.89 2.21 ± 0.89 2.00 ± 0.67 (Score 0-3) Alveolar Edema  0 ± 0^(a)   0 ± 0 57.1 ± 51.4 61.5 ± 50.6 50.0 ± 51.9 50.0 ± 52.7 (%Positive Slides) Alveolar Hemorrhage   0 ± 0   0 ± 0   0 ± 0  7.7 ± 27.7 7.1 ± 26.7   0 ± 0 (% Positive Slides) Presence of Type II  6.7 ±258^(b) 66.7 ± 48.8 78.6 ± 42.6 84.6 ± 37.6 85.7 ± 36.3 80.0 ± 42.2Pneumocyte Hyperplasia (% Positive Slides) Severity of Bronchiolitis0.07 ± 0.26^(a) 0.47 ± 0.52 0.78 ± 0.58 0.77 ± 0.44 0.71 ± 0.47 0.70 ±0.48 (Score 0-3) Extent of Lymphocytic 0.53 ± 0.64 0.33 ± 0.62 1.00 ±0.55 0.92 ± 0.86 0.93 ± 0.73 1.00 ± 0.67 Cuffing (Score 0-3) Severity ofTracheitis/   0 ± 0   0 ± 0   0 ± 0   0 ± 0   0 ± 0   0 ± 0 Bronchitis(Score 0-3) Data Represent Mean ± Std Dev ^(a)P < 0.05 vs. IrrelvantHuman IgG1 Groups One-Way ANOVA (Kruskal-Wallis test) and Dunn's PostHoc Test ^(b)P < 0.005 vs. Irrelvant Human IgG1 Groups

TABLE 24 Day 1 IHC and Day 14 pi Lung Pathology in H3N2 InfluenzaInfected CD-1 Mice Treated with Different Doses of VIS410 and IrrelevantHuman IgG1 VIS410 Placebo Immunohistochemistry 20 mg/kg 2 mg/kg 0.2mg/kg 0.02 mg/kg 20 mg/kg 0.02 mg/kg Trachea/Primary + − − − ++ −Bronchus (IHC) NP NP ++ − ++ ++ − NP + ++ NP ++ − ++ ++ − + − − − − − ++++ Bronchioles (IHC) − − − − − − − − − − − + − − − − − − − − − − − − − −− − − − IHC Immunohistochemistry for influenza A Virus Nucleoprotein(NP) Demonstrating Virus Replication NP Not Present, Therefor NotEvaluated IHC Score: − All negative +/− 1-Few Nuclei Stain FaintlyPositive for IAV-NP or “Suspect Positive” + Few Nuclei Stain Positivefor IAV-NP ++ Several Nuclei Stain Positive for IAV-NP +++ Many NucleiStain Positive for IAV-NP VIS410 Placebo Pathology 20 mg/kg 2 mg/kg 0.2mg/kg 0.02 mg/kg 20 mg/kg 0.02 mg/kg Extend of Alveolitis 0.14 ± 0.36b0.60 ± 0.63 1.07 ± 0.59 1.71 ± 0.91 1.29 ± 0.61 1.57 ± 0.94 (Score 0-3)Severity of Alveolitis 0.14 ± 0.36b 0.73 ± 0.80 1.60 ± 0.98 2.14 ± 1.031.64 ± 0.74 1.64 ± 0.93 (Score 0-3) Alveolar Edema   0 ± 0  6.7 ± 25.8 6.7 ± 25.8 35.7 ± 49.7 21.4 ± 42.6 28.6 ± 46.9 (% Positive Slides)Alveolar Hemorrhage   0 ± 0   0 ± 0   0 ± 0   0 ± 0   0 ± 0  7.1 ± 26.7(% Positive Slides) Presence of Type II   0 ± 0a 20.0 ± 41.4a 53.3 ±51.6 78.6 ± 42.6 78.6 ± 42.6 57.1 ± 51.4 Pneumocyte Hyperplasia (%Positive Slides) Severity of Bronchiolitis   0 ± 0b 0.20 ± 0.41 0.53 ±0.52 0.64 ± 0.63 0.71 ± 0.61 0.50 ± 0.65 (Score 0-3) Extent ofLymphocytic 0.71 ± 0.73 0.67 ± 0.62 0.93 ± 0.70 1.07 ± 0.73 0.78 ± 0.780.93 ± 0.73 Cuffing (Score 0-3) Severity of Tracheitis/ 0.07 ± 0.27   0± 0  0.7 ± 0.26 0.14 ± 0.36   0 ± 0 0.08 ± 0.28 Bronchitis (Score 0-3)Data Represent Mean ± Std Dev aP < 0.05 vs. Irrelvant Human IgG1 GroupsOne-Way ANOVA (Kruskal-Wallis test) and Dunn's Post Hoc Test bP < 0.005vs. Irrelvant Human IgG1 Groups

Thus, in a sub-lethal mouse model of influenza A virus infection, VIS410was protective at the highest doses (e.g., 2 and 20 mg/kg) while atsuboptimal (e.g., sub-therapeutic) doses VIS410 neither protected norelicited ADE, e.g., as measured by morbidity, mortality, virology andpathology assessments.

Example 7: Anti-Influenza Antibody VIS410 Targets a Broadly ConservedEpitope on Hemagglutinin

Given the rapid evolution of HA, a sequence analysis of historical andcurrently circulating influenza strains was performed to monitor theconservation and evolution of VIS410 epitope residues, and the impact ofthese observed polymorphisms on binding and neutralization was assessed.

Methods

The VIS410 epitope was predicted using experimental data and in silicoantibody docking methods. Sequences of influenza HA from varioussubtypes were collected from GenBank and the Global Initiative onSharing Avian Influenza Data (GISAID). A bioinformatics analysis wasperformed to analyze the composition and evolution of amino acids foundat VIS410 epitope positions in HA. ELISA was used to assay VIS410 forbinding to HAs that differ in epitope amino acids, and virusneutralization assays were used to assess VIS410's ability to neutralizeinfluenza viruses with epitope variation.

Results

VIS410 binds to an epitope that is highly conserved in group 1 and group2 HAs and an analysis of over 44,000 sequences shows that the naturalvariability in these residues is limited within each group.Polymorphisms at epitope positions that occur at >1% were identified andinterrogated in the context of existing strains harboring thesemutations. VIS410 neutralized influenza virus strains that togethercovered >97% of the observed positional variability at each epitopeposition in H1 strains and >93% of the positional variability at eachepitope position in H3 strains. Furthermore, when combined with ELISAbinding data, VIS410 was empirically shown to bind to epitopes withamino acid content found in >99% of HA sequences.

Specifically, to assess VIS410's breadth of binding and tolerance tosequence variation, a panel of seasonal influenza strains were selectedwith diverse geographic origin and spanning 4 decades. Strainsexhibiting polymorphisms at the VIS410 epitope were identified based ona sequence analysis of available HA sequences, and were included in thepanel. Strains were included that contain sequence diversity at epitopepositions where the most frequently amino acid was observed at <95%(orange columns below). VIS410 successfully neutralized this diversepanel of strains in a cell-based microneutralization assay. The resultsare shown in FIG. 18.

H1N1 sequences were analyzed for isolates collected from 2005 through2016 (obtained from EpiFlu). In order to monitor the trajectory of thesequence diversity, the sequence entropy for epitope residues as well asall surface residues were calculated over this time period. The meansequence entropy is shown using a heatmap (FIG. 19). VIS410 epitoperesidues show lower sequence entropy (higher conservation) thannon-epitope surface residues. Of note in this analysis, even during the2009 H1N1 pandemic, the VIS410 epitope showed little sequencevariability.

Thus, VIS410 displays broad binding and neutralization and is tolerantto observed polymorphisms in its epitope including newly emergingmutations found in currently circulating strains.

INCORPORATION BY REFERENCE

All publications, patents, and patent applications mentioned herein arehereby incorporated by reference in their entirety as if each individualpublication, patent or patent application was specifically andindividually indicated to be incorporated by reference. In case ofconflict, the present application, including any definitions herein,will control.

EQUIVALENTS

Those skilled in the art will recognize, or be able to ascertain usingno more than routine experimentation, many equivalents to the specificembodiments of the invention described herein. Such equivalents areintended to be encompassed by the following claims.

1.-22. (canceled)
 23. A method of treating a human subject, the methodcomprising administering to the subject an amount of an anti-HA antibodymolecule of between 11 and 16 mg/kg, wherein the anti-HA antibodymolecule comprises: (a) a heavy chain immunoglobulin variable regionsegment comprising: a CDR1 comprising the sequence of SEQ ID NO:68; aCDR2 comprising the sequence of SEQ ID NO:69; and a CDR3 comprising thesequence of SEQ ID NO:70; and (b) a light chain immunoglobulin variableregion segment comprising: a CDR1 comprising the sequence of SEQ ID NO:145; a CDR2 comprising the sequence of SEQ ID NO:72; and a CDR3comprising the sequence of SEQ ID NO:73, thereby treating the subject.24. The method of claim 23, wherein the subject is infected, or is atrisk of being infected, with an influenza virus.
 25. The method of claim23, wherein the antibody molecule is administered to prevent the subjectfrom influenza, or a disorder associated with influenza.
 26. The methodof claim 23, wherein the influenza virus is an H1N1 virus, an H3N2virus, an H7N9 virus, or a combination thereof.
 27. The method of claim23, wherein the antibody molecule is administered at a dose of between12 and 14 mg/kg.
 28. The method of claim 23, wherein the antibodymolecule is administered at a dose of between 11 and 14 mg/kg.
 29. Themethod of claim 23, wherein the antibody molecule is administered at adose of between 11 and 12 mg/kg.
 30. The method of claim 23, wherein thesubject is 65 years of age or above.
 31. The method of claim 23, whereinthe antibody molecule is administered 1 to 15 weeks prior to the date ofan epidemic peak of influenza in a region where the subject resides. 32.The method of claim 23, wherein the antibody molecule is administered 2to 10 weeks prior to the date of an epidemic peak of influenza in aregion where the subject resides.
 33. The method of claim 23, whereinthe antibody molecule is administered 4 to 8 weeks prior to the date ofan epidemic peak of influenza in a region where the subject resides. 34.The method of claim 23, wherein the subject resides in a single-familyresidence, an assisted living facility, a hospital, nursing home, or aninstitution in which more than 2 unrelated people reside.
 35. The methodof claim 23, wherein administering comprises a single intravenousinfusion.
 36. The method of claim 23, further comprising administeringto the subject a second therapeutic agent for influenza, or a disorderor symptom associated with influenza.
 37. The method of claim 23,wherein said antibody molecule comprises a heavy chain immunoglobulinvariable region segment that comprises SEQ ID NO:
 25. 38. The method ofclaim 23, wherein said antibody molecule comprises a light chainimmunoglobulin variable region segment that comprises SEQ ID NO:
 52. 39.The method of claim 23, wherein said antibody molecule comprises a heavychain immunoglobulin variable region segment that comprises SEQ ID NO:25 and a light chain immunoglobulin variable region segment thatcomprises SEQ ID NO:
 52. 40. The method of claim 23, wherein saidantibody molecule is an IgG antibody.
 41. A method of treating a humansubject, the method comprising administering to the subject an amount ofan anti-HA antibody molecule of between 11 and 16 mg/kg, wherein thesubject is infected, or is at risk of being infected, with an influenzavirus, and is 65 years of age or above; and wherein the anti-HA antibodymolecule comprises: (a) a heavy chain immunoglobulin variable regionsegment comprising: a CDR1 comprising the sequence of SEQ ID NO:68; aCDR2 comprising the sequence of SEQ ID NO:69; and a CDR3 comprising thesequence of SEQ ID NO:70; and (b) a light chain immunoglobulin variableregion segment comprising: a CDR1 comprising the sequence of SEQ ID NO:145; a CDR2 comprising the sequence of SEQ ID NO:72; and a CDR3comprising the sequence of SEQ ID NO:73, thereby treating the subject.42. A method of preventing a human subject from becoming infected withinfluenza virus, the method comprising administering to the subject anamount of an anti-HA antibody molecule of between 11 and 16 mg/kg,wherein the anti-HA antibody molecule is administered 1 to 15 weeksprior to the date of an epidemic peak of influenza in a region thatincludes the city, province or state, in which the subject lives; andwherein the anti-HA antibody molecule comprises: (a) a heavy chainimmunoglobulin variable region segment comprising: a CDR1 comprising thesequence of SEQ ID NO:68; a CDR2 comprising the sequence of SEQ IDNO:69; and a CDR3 comprising the sequence of SEQ ID NO:70; and (b) alight chain immunoglobulin variable region segment comprising: a CDR1comprising the sequence of SEQ ID NO: 145; a CDR2 comprising thesequence of SEQ ID NO:72; and a CDR3 comprising the sequence of SEQ IDNO:73, thereby preventing the subject from becoming infected withinfluenza virus.